Oster Natalia V, Geller Berta M, Carney Patricia A, Reisch Lisa M, Onega Tracy, Weaver Donald L, Frederick Paul, Elmore Joann G
Division of General Internal Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA.
Department of Family Medicine, University of Vermont Burlington, 1 South Prospect Street, Burlington, VT 05401, USA.
Breast. 2015 Apr;24(2):107-11. doi: 10.1016/j.breast.2014.10.003. Epub 2014 Dec 29.
Physician attributes, job satisfaction and confidence in clinical skills are associated with enhanced performance and better patient outcomes. We surveyed 252 pathologists to evaluate associations between enjoyment of breast pathology, demographic/clinical characteristics and diagnostic performance. Diagnostic performance was determined by comparing pathologist assessments of a set of 60 cases with consensus assessments of the same cases made by a panel of experienced pathologists. Eighty-three percent of study participants reported enjoying breast pathology. Pathologists who enjoy breast interpretation were more likely to review ≥10 cases/week (p = 0.003), report breast interpretation expertise (p = 0.013) and have high levels of confidence interpreting breast pathology (p < 0.001). These pathologists were less likely to report that the field was challenging (p < 0.001) and that breast cases make them more nervous than other types of pathology (p < 0.001). Enjoyment was not associated with diagnostic performance. Millions of women undergo breast biopsy annually, thus it is reassuring that although nearly a fifth of practicing pathologists who interpret breast tissue report not enjoying the field, precision is not impacted.
医生的特质、工作满意度和临床技能信心与更高的工作表现及更好的患者治疗效果相关。我们对252名病理学家进行了调查,以评估乳腺病理学兴趣、人口统计学/临床特征与诊断表现之间的关联。通过将一组60例病例的病理学家评估结果与由一组经验丰富的病理学家做出的相同病例的一致性评估结果进行比较,来确定诊断表现。83%的研究参与者表示喜欢乳腺病理学。喜欢乳腺病理解读的病理学家更有可能每周复查≥10例病例(p = 0.003),报告乳腺病理解读专业知识(p = 0.013),并且在解读乳腺病理时有较高的信心水平(p < 0.001)。这些病理学家不太可能报告该领域具有挑战性(p < 0.001),以及乳腺病例比其他类型的病理学更让他们紧张(p < 0.001)。兴趣与诊断表现无关。每年有数百万女性接受乳腺活检,因此令人安心的是,尽管近五分之一解读乳腺组织的执业病理学家表示不喜欢该领域,但诊断准确性并未受到影响。