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住院医师学术活动的成本及其对住院医师临床经验的影响。

The cost of resident scholarly activity and its effect on resident clinical experience.

机构信息

From the *Department of Anesthesiology, University of Pittsburgh Medical Center; and †Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

出版信息

Anesth Analg. 2013 Nov;117(5):1211-6. doi: 10.1213/ANE.0b013e3182a44d5d.

Abstract

BACKGROUND

Scholarly activity is an important aspect of the academic training of future anesthesiologists. However, residents' scholarly activity may reduce training caseloads and increase departmental costs.

METHODS

We conducted this study within a large academic anesthesiology residency program with data from the 4 graduating classes of 2009 through 2012. Scholarly activity included peer-reviewed manuscripts, case reports, poster presentations at conferences, book chapters, or any other publications. It was not distinguished whether a resident was the principal investigator or a coinvestigator on a project. The following data were collected on each resident: months spent on a resident research rotation, number of scholarly projects completed, number of research conferences attended, and Accreditation Council for Graduate Medical Education case entries. Comparison was made between residents electing a resident research rotation with those who did not for (1) scholarly projects, (2) research conference attendance, and (3) Accreditation Council for Graduate Medical Education case numbers. Cost to the department for extra clinical coverage during residents' time spent on research activities was calculated using an estimated average cost of $675 ± $176 (mean ± SD) per day with local certified registered nurse anesthetist pay scales.

RESULTS

Sixty-eight residents were included in the analyses. Twenty-four residents (35.3%) completed resident research rotations with an average duration of 3.7 months. Residents who elected resident research rotations completed more scholarly projects (5 projects [4-6]: median [25%-75% interquartile range] vs 2 [0-3]; P < 0.0001), attended more research conferences (2 conferences [2-4] vs 1 [0-2]; P < 0.0001), but experienced fewer cases (980 cases [886-1333] vs 1182 [930-1420]; P ≤ 0.002) compared with those who did not elect resident research rotations. The estimated average cost to the department per resident who elected a resident research rotation was $13,500 ± $9724 per month. The average resident time length away from duty for conference attendance was 3.2 ± 0.2 days, with an average cost to the department of $2160 ± $565. The average annual departmental expense for resident conference travel was an additional $1424 ± $133 per resident, as calculated from reimbursement data. Together, the estimated departmental cost for resident scholarly activity during the residency training period was $27,467 ± $20,153 per resident.

CONCLUSIONS

Residents' scholarly activities require significant departmental financial support. Residents who elected to spend months conducting research completed significantly more scholarly projects but experienced fewer clinical cases.

摘要

背景

学术活动是未来麻醉师学术培训的一个重要方面。然而,住院医师的学术活动可能会减少培训病例量并增加部门成本。

方法

我们在一个大型学术麻醉住院医师培训计划中进行了这项研究,该计划的数据来自 2009 年至 2012 年的 4 个毕业班级。学术活动包括同行评议的手稿、病例报告、会议海报展示、书籍章节或任何其他出版物。并没有区分住院医师是项目的主要研究员还是共同研究员。收集了每位住院医师的以下数据:在住院医师研究轮转上花费的时间、完成的学术项目数量、参加的研究会议数量以及住院医师毕业后医学教育认证委员会的病例录入。选择住院医师研究轮转的住院医师与未选择的住院医师进行比较:(1)学术项目,(2)研究会议出席情况,(3)住院医师毕业后医学教育认证委员会的病例数量。使用当地认证注册护士麻醉师薪酬标准,计算了住院医师在研究活动期间额外临床覆盖的部门成本,估计平均每天$675 ± $176(平均值 ± SD)。

结果

共纳入 68 名住院医师进行分析。24 名住院医师(35.3%)完成了为期 3.7 个月的住院医师研究轮转。选择住院医师研究轮转的住院医师完成了更多的学术项目(5 项[4-6]:中位数[25%-75%四分位数间距]与 2 项[0-3];P < 0.0001),参加了更多的研究会议(2 次会议[2-4]与 1 次会议[0-2];P < 0.0001),但经历的病例数较少(980 例[886-1333]与 1182 例[930-1420];P ≤ 0.002)。选择住院医师研究轮转的住院医师,部门每月的平均费用为$13500 ± $9724。住院医师为参加会议而离开工作岗位的平均时间为 3.2 ± 0.2 天,部门平均费用为$2160 ± $565。从报销数据中计算得出,住院医师参加会议的年度部门费用为每位住院医师$1424 ± $133。因此,住院医师在住院医师培训期间的部门学术活动的估计部门费用为每位住院医师$27467 ± $20153。

结论

住院医师的学术活动需要部门提供大量资金支持。选择花几个月时间进行研究的住院医师完成的学术项目明显更多,但临床病例较少。

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