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学徒制缓解独立呼叫的过渡:对初级放射科住院医师焦虑和信心的评估。

Apprenticeships ease the transition to independent call: an evaluation of anxiety and confidence among junior radiology residents.

机构信息

Department of Radiology, University of Michigan Health System, Ann Arbor, 48109, USA.

出版信息

Acad Radiol. 2011 Sep;18(9):1186-94. doi: 10.1016/j.acra.2011.04.015. Epub 2011 Jun 29.

Abstract

RATIONALE AND OBJECTIVES

The aims of this study were to quantify resident anxiety when beginning independent call and to assess whether an apprenticeship experience (buddy call) can lessen anxiety and improve confidence.

MATERIALS AND METHODS

A prospective cohort comparison of two groups of radiology residents beginning independent call, one of which was provided with a buddy call experience, was performed. Anxiety and confidence were assessed using the Endler Multidimensional Anxiety Scales-State (EMAS-S), with total score, autonomic emotional, and cognitive worry components, and a five-point, Likert-type scale, respectively. Both groups were asked about the perceived value of a buddy call experience.

RESULTS

EMAS-S scores improved significantly over 5 days of call in both groups (control, n = 10, P = .0005; buddy call, n = 9, P = .0001), and image interpretation confidence correspondingly increased (control, P = .0004; buddy call, P = .003). Compared to the control group, autonomic emotional scores were significantly lower in the buddy call group on the first day of independent call (P = .040), and cognitive worry and total EMAS-S scores were significantly lower on day 5 (both P values = .03). Buddy call was independently associated with improved autonomic emotional and film interpretation confidence scores (both P values = .02). All members of the buddy call group indicated that the experience was very helpful in preparing for call.

CONCLUSIONS

Beginning independent call is associated with high anxiety, and buddy call reduces that anxiety, beyond the effect of time alone. Residents who participated in buddy call found it helpful in preparing for independent call. These findings support the use of buddy call and tiered call structures as means to introduce junior residents to independent call.

摘要

背景与目的

本研究旨在量化住院医师开始独立值班时的焦虑程度,并评估学徒经历(帮带值班)是否能减轻焦虑并提高信心。

材料与方法

对两组开始独立值班的放射科住院医师进行前瞻性队列比较,其中一组提供帮带值班经验。使用多维焦虑量表状态分量表(Endler Multidimensional Anxiety Scales-State,EMAS-S)评估焦虑和信心,分别采用总分、自主情绪和认知担忧分量表和 5 分李克特量表进行评估。两组均被问及对帮带值班经验的看法。

结果

两组在值班的 5 天内,EMAS-S 评分均显著改善(对照组,n = 10,P =.0005;帮带值班组,n = 9,P =.0001),图像解读信心也相应提高(对照组,P =.0004;帮带值班组,P =.003)。与对照组相比,帮带值班组在独立值班的第一天自主情绪评分显著较低(P =.040),第 5 天认知担忧和 EMAS-S 总分评分显著较低(均 P 值 =.03)。帮带值班与自主情绪和影片解读信心评分的改善独立相关(均 P 值 =.02)。帮带值班组的所有成员都表示,该经验在准备值班方面非常有帮助。

结论

开始独立值班与高度焦虑相关,而帮带值班除了时间因素外,还能减轻这种焦虑。参与帮带值班的住院医师发现,这有助于他们为独立值班做准备。这些发现支持使用帮带值班和分层值班结构,让初级住院医师逐渐适应独立值班。

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