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住院医师如何看待主治医生在临床环境中提供的监督质量。

How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting.

作者信息

Busari Jamiu O, Weggelaar Nielske M, Knottnerus Andrieke C, Greidanus Petra-Marie, Scherpbier Albert J J A

机构信息

Department of Paediatrics, St Lucas Andreas Hospital, Amsterdam, The Netherlands.

出版信息

Med Educ. 2005 Jul;39(7):696-703. doi: 10.1111/j.1365-2929.2005.02190.x.

Abstract

INTRODUCTION

The supervision of medical residents is a key responsibility of attending doctors in the clinical setting. Most attending doctors, however, are unfamiliar with the principles of effective supervision. Although inconsistent, supervision has been shown to be both important and effective for the professional development of medical residents.

OBJECTIVE

To examine how medical residents perceive the supervisory roles of attending doctors, in terms of what they perceive as poor supervision and what they characterise as good supervisory practice.

METHOD

We carried out a questionnaire survey of 38 medical residents at the Department of Paediatrics at the teaching hospital of the University of Amsterdam, the Netherlands. Attending doctors directly involved with the supervision of medical residents participated in the study. The clinical settings where supervision occurred included the neonatal and paediatric intensive care units and the general paediatric wards.

RESULTS

Medical residents rated the quality of supervision they received in all departments positively. A majority of the attending doctors were rated highly in 'overall supervision'. Creating pleasant learning environments and being stimulated to learn and function independently were aspects of supervision characterised positively. Coaching in clinical skills and procedures, effective communication skills and clinical decision making using principles of cost-appropriate care were aspects of supervision found to be deficient.

DISCUSSION

This study shows that medical residents enjoy supervision from collaborative, understanding and patient attending doctors. Medical residents prefer to be treated as adult learners and enjoy feedback that is constructive, measured and adapted to their professional needs.

摘要

引言

在临床环境中,指导住院医生是主治医生的一项关键职责。然而,大多数主治医生并不熟悉有效指导的原则。尽管指导情况并不一致,但已证明指导对住院医生的职业发展既重要又有效。

目的

探讨住院医生如何看待主治医生的指导角色,包括他们认为的不良指导以及他们所描述的良好指导实践。

方法

我们对荷兰阿姆斯特丹大学教学医院儿科的38名住院医生进行了问卷调查。直接参与指导住院医生的主治医生参与了该研究。指导发生的临床环境包括新生儿和儿科重症监护病房以及普通儿科病房。

结果

住院医生对他们在所有科室接受的指导质量给予了积极评价。大多数主治医生在“总体指导”方面得到了高度评价。营造愉快的学习环境以及被激励独立学习和发挥作用是指导中得到积极评价的方面。临床技能和操作指导、有效的沟通技巧以及运用成本适宜护理原则进行临床决策是指导中被发现存在不足的方面。

讨论

本研究表明,住院医生喜欢来自协作、善解人意且有耐心的主治医生的指导。住院医生希望被当作成年学习者对待,并喜欢具有建设性、适度且符合其职业需求的反馈。

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