Girard Donald E, Choi Dongseok, Dickey Jamie, Dickerson Dina, Bloom Joseph D
Graduate Medical Education, Oregon Health and Science University, 3181 SW Sam Jackson Park Road L-102, Portland, OR 97239, USA.
Med Educ. 2006 Jan;40(1):79-86. doi: 10.1111/j.1365-2929.2005.02350.x.
To evaluate career satisfaction, emotional states and positive and negative experiences among residents in primary care and speciality programmes in 1 academic medical centre prior to the implementation of the Accreditation Council for Graduate Medical Education's (ACGME) duty hour requirements.
Cross-sectional survey.
All 581 residents in the academic health centre were asked to participate voluntarily in a confidential survey; 327(56%) completed the survey.
Compared to their primary care colleagues, speciality residents had higher levels of satisfaction with career choice, feelings of competence and excitement, lower levels of inferiority and fatigue and different perceptions of positive and negative training experiences. However, 77% of all respondents were consistently or generally pleased with their career choices. The most positive residents' experiences related to interpersonal relationships and their educational value; the most negative experiences related to interpersonal relationships and issues perceived to be outside of residents' control. Age and training level, but not gender also influenced career satisfaction, emotional states and positive and negative opinions about residency.
Less satisfaction with career choice and more negative emotional states for primary care residents compared to speciality residents probably relate to the training experience and may influence medical students' selections of careers. The primary care residents, compared to speciality residents, appear to have difficulty in fulfilling their ideals of professionalism in an environment where they have no control. These data provide baseline information with which to compare these same factors after the implementation of the ACGME duty hours' and competency requirements.
在研究生医学教育认证委员会(ACGME)工作时间要求实施之前,评估一所学术医疗中心的初级保健和专科项目住院医师的职业满意度、情绪状态以及积极和消极体验。
横断面调查。
学术健康中心的所有581名住院医师被邀请自愿参与一项保密调查;327人(56%)完成了调查。
与初级保健同行相比,专科住院医师对职业选择、胜任感和兴奋感的满意度更高,自卑感和疲劳感更低,对积极和消极培训经历的认知也不同。然而,77%的受访者对自己的职业选择一直或总体上感到满意。住院医师最积极的体验与人际关系及其教育价值有关;最消极的体验与人际关系以及被认为超出住院医师控制范围的问题有关。年龄和培训水平而非性别也会影响职业满意度、情绪状态以及对住院医师培训的积极和消极看法。
与专科住院医师相比,初级保健住院医师对职业选择的满意度较低,消极情绪状态较多,这可能与培训经历有关,并可能影响医学生的职业选择。与专科住院医师相比,初级保健住院医师在无法掌控的环境中似乎难以实现其职业理想。这些数据提供了基线信息,可用于在ACGME工作时间和能力要求实施后比较相同的因素。