Department of Sociology, University of Pennsylvania, 3718 Locust Walk, Suite 113, Philadelphia, PA 19104, USA.
Soc Sci Med. 2012 Nov;75(9):1625-32. doi: 10.1016/j.socscimed.2012.07.007. Epub 2012 Jul 27.
We examine how a policy aimed at improving patient safety by limiting residents' work hours brought with it an unintended and unexamined consequence: altered socialization due to modified rites of passage during residency that endangered the stereotypical "Surgical Personality" and created a potential rift between the occupational identities of surgical residents who train under duty hour regulations and those who trained before they were imposed. Through participant observation occurring between June 2008 and June 2010, in-depth interviews (n = 13), and focus groups (n = 2), we explore how surgical residents training in four U.S. hospitals think about the threats that the shift from unrestricted to restricted duty hours creates for their claims of competence and professionalism. We identify three types of resident responses: (1) neutralizing statements that deny any significant change to occupational identity has occurred; (2) embracing statements that express the belief that a changed and more balanced occupational identity is needed; and (3) apprehensive statements that expressed fear of an altered occupational identity and an anxiety about readiness for individual practice.
我们研究了一项旨在通过限制住院医师工作时间来提高患者安全的政策，该政策带来了一个意料之外且未经检验的后果：由于住院医师期间的仪式发生了变化，导致社会化发生了变化，这危及了典型的“外科人格”，并在遵守工作时间规定的外科住院医师的职业身份和那些在规定实施之前接受培训的住院医师之间造成了潜在的裂痕。通过在 2008 年 6 月至 2010 年 6 月期间进行的参与式观察、深入访谈（n=13）和焦点小组（n=2），我们探讨了在美国四家医院接受培训的外科住院医师如何看待从无限制到限制工作时间的转变对他们的能力和专业精神主张所构成的威胁。我们确定了三种类型的住院医师反应：（1）否认职业身份发生任何重大变化的中立声明；（2）表达相信需要改变和更加平衡的职业身份的声明；（3）对改变职业身份的担忧和对个人实践准备情况的焦虑的担忧声明。
