Davenport Daniel L, Henderson William G, Hogan Shomari, Mentzer Robert M, Zwischenberger Joseph B
Department of Surgery, University of Kentucky, Lexington, KY 40536-0298, USA.
Surgery. 2008 Aug;144(2):332-338.e5. doi: 10.1016/j.surg.2008.03.038.
Medical students demonstrate decreased interest in surgical residencies and resident attrition after entry into programs has been reported at 14% to 20%. This study surveyed surgery residents regarding working conditions and how those conditions influenced their job satisfaction.
A new survey was developed to measure residents' working conditions. Questions generated from literature review were expanded and validated through focus groups at 2 academic medical centers. The resulting survey was administered on general/vascular surgery services at 52 hospitals along with a job-satisfaction scale. Questions were grouped into composite measures using factor analysis. Correlations were calculated between working conditions and job satisfaction at the individual and the hospital level.
In 844 returned surveys, resident job satisfaction did not correlate with age, sex, or postgraduate year. Perceived quality of patient care was the strongest (R = .51) of 68 items that did correlate (P < .01). Duty hours correlated less strongly (R = -.17). At the aggregate hospital level, effective ancillary staff/services (R = .77), empathetic nurses (R = .69), and attending teaching, appreciation and openness to suggestions (R = .49) correlated positively; scutwork (R = -.63) and erroneous paging (R = -.37) correlated negatively.
Our data confirm prior studies indicating that the teaching skills of the attending and the duty hours influence resident satisfaction. More important than these factors, however, were the effectiveness of systems and staff that facilitate the residents' job-care of the patient. Resident satisfaction and student recruitment efforts could be enhanced by the Program and Hospital Director's correction of deficiencies in these areas.
医学生对外科住院医师培训项目的兴趣有所下降,且据报道,进入项目后的住院医师流失率在14%至20%之间。本研究对外科住院医师的工作条件以及这些条件如何影响他们的工作满意度进行了调查。
开发了一项新的调查问卷来衡量住院医师的工作条件。通过对文献综述中提出的问题进行扩展,并在2个学术医疗中心通过焦点小组进行验证。最终的调查问卷在52家医院的普通/血管外科科室实施,并同时使用工作满意度量表。通过因子分析将问题分组为综合指标。计算了个体层面和医院层面工作条件与工作满意度之间的相关性。
在844份回收的调查问卷中,住院医师的工作满意度与年龄、性别或研究生年级无关。在68项具有相关性的项目中(P <.01),感知到的患者护理质量相关性最强(R =.51)。值班时长的相关性较弱(R = -.17)。在医院总体层面,有效的辅助人员/服务(R =.77)、富有同情心的护士(R =.69)以及主治医生的教学、对建议的认可和开放性(R =.49)呈正相关;杂务(R = -.63)和错误传呼(R = -.37)呈负相关。
我们的数据证实了先前的研究,表明主治医生的教学技能和值班时长会影响住院医师的满意度。然而,比这些因素更重要的是有助于住院医师照顾患者工作的系统和人员的有效性。项目负责人和医院主任纠正这些领域的不足,可能会提高住院医师的满意度并增强学生招募工作。