Fletcher Kathlyn E, Visotcky Alexis M, Slagle Jason M, Tarima Sergey, Whittle Jeff, Weinger Matthew B, Schapira Marilyn M
J Grad Med Educ. 2013 Sep;5(3):427-32. doi: 10.4300/JGME-D-12-00241.1.
Workload has traditionally been measured by using surrogates, such as number of patients admitted or census, but these may not fully represent the complex concept of workload.
We measured self-reported subjective workload of interns and explored the relationship between subjective workload and possible predictors of it.
Trained research assistants observed internal medicine interns on call on a general medicine service. Approximately once an hour, the research assistants recorded the self-reported subjective workload of the interns by using Borg's Self-Perceived Exertion Scale, a 6 to 20 scale, and also recorded their own perceptions of the intern's workload. Research assistants continuously recorded the tasks performed by the interns. Interns were surveyed before and after the observation to obtain demographic and census data.
Our sample included 25 interns, with a mean age of 28.6 years (SD, 2.4 years). Mean self-reported subjective workload was 12.0 (SD, 2.4). Mean self-reported subjective workload was significantly correlated with intern age (r = 0.49, P < .05), but not with team or intern census, number of admissions, or number of patients cross-covered. Self-reported subjective workload in the period after sign-out was significantly higher than in the period before and during sign-out (P < .001).
Self-reported subjective workload was not associated with traditional measures of workload. However, receiving sign-out and assuming the care of cross-coverage patients may be related to higher subjective workload in interns. Given the patient safety implications of workload, it is important that the medical education community have tools to evaluate workload and identify contributors to it.
传统上，工作量是通过使用替代指标来衡量的，例如收治患者的数量或普查人数，但这些可能无法完全代表工作量这一复杂概念。
我们测量了实习生自我报告的主观工作量，并探讨了主观工作量与其可能的预测因素之间的关系。
经过培训的研究助理观察了在内科普通病房值班的内科实习生。研究助理大约每小时记录一次实习生自我报告的主观工作量，使用的是博格自感劳累量表（6至20分制），同时也记录他们自己对实习生工作量的看法。研究助理持续记录实习生执行的任务。在观察前后对实习生进行调查，以获取人口统计学和普查数据。
我们的样本包括25名实习生，平均年龄为28.6岁（标准差为2.4岁）。自我报告的平均主观工作量为12.0（标准差为2.4）。自我报告的平均主观工作量与实习生年龄显著相关（r = 0.49，P < 0.05），但与团队或实习生普查人数、入院人数或交叉负责的患者人数无关。交班后自我报告的主观工作量显著高于交班期间和交班之前（P < 0.001）。
自我报告的主观工作量与传统的工作量衡量指标无关。然而，接收交班信息并承担交叉负责患者的护理工作可能与实习生较高的主观工作量有关。鉴于工作量对患者安全的影响，医学教育界拥有评估工作量并确定其影响因素的工具非常重要。
