Department of Surgery, Loyola University Chicago, Stritch School of Medicine, Maywood, IL.
Association of American Medical Colleges, Washington, DC.
J Am Coll Surg. 2014 Jul;219(1):31-42. doi: 10.1016/j.jamcollsurg.2014.03.027. Epub 2014 Mar 22.
Academic medical centers strive for clinical excellence with operational efficiency and financial solvency, which requires institutions to retain productive and skillful surgical specialists. Faculty workplace perceptions, overall satisfaction, and intent to leave are relationships that have not been examined previously among US surgeons in academic medicine. We hypothesize that critical factors related to workplace satisfaction and engagement could be identified as important for enhancing institutional retention of academic surgeons.
The 2011-2012 Association of American Medical Colleges Faculty Forward Engagement Survey evaluated demographic variables, physician workplace satisfaction, and overall engagement among faculty subgroups, including comparison of surgical and nonsurgical clinicians. Multiple regression analysis (β = standard regression coefficient) was performed to identify critical factors most closely related to surgeon satisfaction and intent to leave their institutions.
A total of 1,356 of 1,949 (70%) surgeons from 14 medical schools responded across different faculty subgroups, and comparisons were made with 1,105 nonsurgical clinicians. Multiple regression indicated that the strongest predictors of surgeons' overall satisfaction with their department included department governance (β = 0.36; p < 0.001), collegiality and collaboration (β = 0.23; p < 0.001), and relationship with supervisor (β = 0.17; p < 0.001). Although compensation and benefits were important (β = 0.08; p < 0.001), these did not rank as the most important factors. Promotion equality (odds ratio = 0.62; p < 0.05), collegiality and collaboration (odds ratio = 0 .51; p < 0.05), and nature of their work (odds ratio = 0.52; p < 0.05) were most closely related to intent to leave the medical school within 1 to 2 years.
In the largest survey focusing on workplace factors affecting surgical faculty satisfaction and intent to leave, we conclude that institutional understanding of, and improvement in, specific work environment factors can enhance recruitment and retention of academic surgeons.
学术医学中心致力于实现临床卓越、提高运营效率和保持财务稳健,这要求医疗机构留住富有成效和技能娴熟的外科专家。在美国学术医学领域的外科医生中,目前尚未对教职员工工作场所的认知、整体满意度和离职意向之间的关系进行研究。我们假设,与工作场所满意度和参与度相关的关键因素,可以确定为增强学术外科医生机构保留率的重要因素。
2011-2012 年美国医学院协会教职员工前瞻性参与度调查评估了教员的人口统计学变量、医生工作场所满意度和整体参与度,包括对手术和非手术临床医生的比较。采用多元回归分析(β=标准回归系数)来确定与外科医生满意度和离开机构意向最密切相关的关键因素。
共有来自 14 所医学院的 1949 名外科医生中的 1356 名(70%)医生在不同的教职员工亚组中做出了回应,并与 1105 名非手术临床医生进行了比较。多元回归表明,外科医生对其科室整体满意度的最强预测因素包括科室治理(β=0.36;p<0.001)、同事关系和协作(β=0.23;p<0.001)以及与主管的关系(β=0.17;p<0.001)。尽管薪酬和福利很重要(β=0.08;p<0.001),但它们并不是最重要的因素。晋升机会均等(比值比=0.62;p<0.05)、同事关系和协作(比值比=0.51;p<0.05)以及工作性质(比值比=0.52;p<0.05)与 1 至 2 年内离开医学院的意向最密切相关。
在针对影响外科教员满意度和离职意向的工作场所因素的最大规模调查中,我们得出结论,机构对特定工作环境因素的理解和改进可以增强对学术外科医生的招聘和保留。