家庭医学专业毕业生在住院医师培训期间对恐吓、骚扰和歧视的看法。
Family medicine graduates' perceptions of intimidation, harassment, and discrimination during residency training.
机构信息
Department of Family Medicine, University of Calgary, NW, Calgary, Alberta, Canada.
出版信息
BMC Med Educ. 2011 Oct 24;11:88. doi: 10.1186/1472-6920-11-88.
BACKGROUND
Despite there being considerable literature documenting learner distress and perceptions of mistreatment in medical education settings, these concerns have not been explored in-depth in Canadian family medicine residency programs. The purpose of the study was to examine intimidation, harassment and/or discrimination (IHD) as reported by Alberta family medicine graduates during their two-year residency program.
METHODS
A retrospective questionnaire survey was conducted of all (n = 377) family medicine graduates from the University of Alberta and University of Calgary who completed residency training during 2001-2005. The frequency, type, source, and perceived basis of IHD were examined by gender, age, and Canadian vs international medical graduate. Descriptive data analysis (frequency, crosstabs), Chi-square, Fisher's Exact test, analysis of variance, and logistic regression were used as appropriate.
RESULTS
Of 377 graduates, 242 (64.2%) responded to the survey, with 44.7% reporting they had experienced IHD while a resident. The most frequent type of IHD experienced was in the form of inappropriate verbal comments (94.3%), followed by work as punishment (27.6%). The main sources of IHD were specialist physicians (77.1%), hospital nurses (54.3%), specialty residents (45.7%), and patients (35.2%). The primary basis for IHD was perceived to be gender (26.7%), followed by ethnicity (16.2%), and culture (9.5%). A significantly greater proportion of males (38.6%) than females (20.0%) experienced IHD in the form of work as punishment. While a similar proportion of Canadian (46.1%) and international medical graduates (IMGs) (41.0%) experienced IHD, a significantly greater proportion of IMGs perceived ethnicity, culture, or language to be the basis of IHD.
CONCLUSIONS
Perceptions of IHD are prevalent among family medicine graduates. Residency programs should explicitly recognize and robustly address all IHD concerns.
背景
尽管有大量文献记录了医学教育环境中的学习者困扰和虐待感知，但这些问题在加拿大家庭医学住院医师培训计划中并未得到深入探讨。本研究的目的是检查艾伯塔省家庭医学毕业生在为期两年的住院医师培训期间报告的恐吓、骚扰和/或歧视（IHD）。
方法
对 2001-2005 年期间在艾伯塔大学和卡尔加里大学完成住院医师培训的所有（n=377）家庭医学毕业生进行了回顾性问卷调查。通过性别、年龄以及加拿大和国际医学毕业生来检查 IHD 的频率、类型、来源和感知基础。使用适当的描述性数据分析（频率、交叉表）、卡方检验、Fisher 精确检验、方差分析和逻辑回归。
结果
在 377 名毕业生中，有 242 名（64.2%）对调查做出了回应，其中 44.7%的人报告在住院医师期间经历过 IHD。经历过的最常见类型的 IHD 是以不当言语评论的形式（94.3%），其次是工作作为惩罚（27.6%）。IHD 的主要来源是专科医生（77.1%）、医院护士（54.3%）、专科住院医师（45.7%）和患者（35.2%）。IHD 的主要依据被认为是性别（26.7%），其次是族裔（16.2%）和文化（9.5%）。经历工作作为惩罚形式的 IHD 的男性比例（38.6%）明显高于女性（20.0%）。虽然加拿大（46.1%）和国际医学毕业生（IMGs）（41.0%）经历 IHD 的比例相似，但 IMGs 认为族裔、文化或语言是 IHD 基础的比例明显更高。
结论
家庭医学毕业生普遍存在对 IHD 的认知。住院医师培训计划应明确认识到并有力解决所有 IHD 问题。
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