Chiapponi Costanza, Meyer Christine Y, Heinemann Silvia, Meyer Frank, Biberthaler Peter, Bruns Christiane J, Kanz Karl-Georg
Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany.
Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
J Surg Educ. 2017 Jan-Feb;74(1):145-153. doi: 10.1016/j.jsurg.2016.06.002. Epub 2016 Jul 26.
Working conditions in hospitals generate stress within all professional groups. The aim of this study was to find out how German medical students during their senior student clerkship in surgery perceive their own stress and the stress of surgical residents. This was measured using "Instrument zur stressbezogenen Arbeitsanalyse bei KlinikÃrztInnen (ISAK-K)," a validated questionnaire of the German statutory occupational accident insurance system (BGW).
This bi-institutional paper-and-pencil survey was performed on 52 medical students in their sixth year, who had been working in a surgical department for 4 months. Data were compared with those of the BGW on the stress perceived by physicians working in German surgical departments.
The stress levels measured with the ISAK-K were similar in students and in physicians working in surgery. Students believe that surgical residents experience a higher time pressure (p < 0.03). Those students planning a surgical career feel to be more exposed to time pressure (p < 0.01), but to be more free to decide how to work (p < 0.03) than their "nonsurgical" colleagues do. In addition, in contrast to the "nonsurgical" students, students interested in surgery believe that surgical residents have more possibilities to learn at work (p < 0.05) and that they can rely on their supervisors (p < 0.03). All students believe that surgical residents commonly need to take decisions without having enough information (p < 0.05). When compared with the BGW data students overestimate the stress of surgical residents.
Students overestimate time pressure and uncertainty of surgical residents. A possible way to increase their interest in surgery is offering a better insight in surgeons' work and strategies to deal with these stressors.
医院的工作环境会给所有专业群体带来压力。本研究旨在了解德国医学专业学生在外科临床实习期间如何看待自己的压力以及外科住院医师的压力。这是通过使用“临床医生压力相关工作分析工具（ISAK-K）”来衡量的，该工具是德国法定职业事故保险系统（BGW）经过验证的问卷。
这项双机构纸笔调查针对52名六年级医学专业学生进行，他们已在外科部门工作4个月。将数据与BGW关于德国外科部门工作的医生所感受到的压力数据进行比较。
用ISAK-K测量的压力水平在学生和外科工作的医生中相似。学生们认为外科住院医师承受着更高的时间压力（p<0.03）。那些计划从事外科职业的学生感觉比他们“不打算从事外科”的同学更容易面临时间压力（p<0.01），但在工作方式的决定上更自由（p<0.03）。此外，与“不打算从事外科”的学生相比，对手术感兴趣的学生认为外科住院医师在工作中有更多学习机会（p<0.05），并且他们可以依靠上级（p<0.03）。所有学生都认为外科住院医师通常需要在信息不足的情况下做出决定（p<0.05）。与BGW数据相比，学生高估了外科住院医师的压力。
学生高估了外科住院医师的时间压力和不确定性。增加他们对手术兴趣的一种可能方法是让他们更好地了解外科医生的工作以及应对这些压力源的策略。
