Nadkarni Girish N, Sabharwal Manpreet Singh, Ammakkanavar Natraj Reddy, Annapureddy Narender, Malhan Rishi, Mehta Bijal, Kanakadandi Vijay Naag, Agarwal Shiv Kumar, Fried Ethan D
Department of Medicine, St Luke's Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Int J Health Care Qual Assur. 2014;27(3):182-9. doi: 10.1108/IJHCQA-05-2012-0049.
Patient satisfaction has been recognized as an important variable affecting healthcare behavior. However, there are limited data on the relationship between doctor post-graduate year (PGY) status and patient satisfaction with provider interpersonal skills and humanistic qualities. The authors aims to assess this relationship using an American Board of Internal Medicine (ABIM) questionnaire.
DESIGN/METHODOLOGY/APPROACH: Participants were: patients attending a primary care clinic at a large urban academic hospital; and physicians treating them. The survey questionnaire was the ABIM patient satisfaction instrument; ten questions pertaining to humanistic qualities and communication skills with responses from poor to excellent. Mann Whitney U test and multi-variable logistic regression analyses were used to explore score differences by PGY level.
The postgraduate year one (PGY1) had higher patient-satisfaction levels compared to PGY2/PGY3 residents. The PGY1 level residents were more likely to score in the 90th percentile and this remained constant even after adjusting for confounders.
RESEARCH LIMITATIONS/IMPLICATIONS: The research was a single-center study and may have been subject to confounding factors such as patient personality types and a survey ceiling effect. The survey's cross-sectional nature may also be a potential limitation. Practical implications - Patient satisfaction varies significantly with PGY status. Though clinical skills may improve with increasing experience, findings imply that interpersonal and humanistic qualities may deteriorate.
ORIGINALITY/VALUE: The study is the first to assess patient satisfaction with PGY status and provides evidence that advanced trainees may need support to keep their communication skills and humanistic qualities from deteriorating as stressors increase to ensure optimal patient satisfaction.
患者满意度已被视为影响医疗行为的一个重要变量。然而，关于医生研究生培训年限（PGY）状态与患者对医疗服务提供者人际技能和人文素质满意度之间关系的数据有限。作者旨在使用美国内科医学委员会（ABIM）问卷评估这种关系。
设计/方法/途径：参与者包括：在一家大型城市学术医院的初级保健诊所就诊的患者；以及治疗这些患者的医生。调查问卷为ABIM患者满意度工具；十个与人文素质和沟通技巧相关的问题，回答从差到优。采用曼-惠特尼U检验和多变量逻辑回归分析来探讨不同PGY水平的得分差异。
与PGY2/PGY3住院医师相比，第一年住院医师（PGY1）的患者满意度更高。PGY1水平的住院医师更有可能得分在第90百分位，即使在调整混杂因素后这一情况仍保持不变。
研究局限性/影响：该研究为单中心研究，可能受到患者性格类型和调查天花板效应等混杂因素的影响。调查的横断面性质也可能是一个潜在的局限性。实际意义——患者满意度随PGY状态有显著差异。虽然临床技能可能会随着经验的增加而提高，但研究结果表明人际和人文素质可能会下降。
原创性/价值：该研究首次评估了患者对PGY状态的满意度，并提供了证据表明，随着压力源增加，高级受训人员可能需要支持，以防止其沟通技能和人文素质下降，从而确保最佳的患者满意度。
