1 Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
2 Department of Nursing, Hungkuang University, Taichung, Taiwan.
Eval Health Prof. 2019 Jun;42(2):233-257. doi: 10.1177/0163278717729732. Epub 2017 Sep 22.
Medical education faces challenges concerning job burnout and emotional labor among junior physicians, which poses a potential threat to the quality of medical care. Although studies have investigated job burnout and emotional labor among physicians, empirical research on the association between job burnout, emotional labor, and clinical performance is lacking. This study investigated the effects of job burnout and emotional labor on clinical performance by using the objective structured clinical examination (OSCE) scores of interns and residents. Specifically, this cross-sectional study utilized the Maslach Burnout Inventory and the Emotional Labor Questionnaire as measurement instruments. A total of 225 interns and residents in central Taiwan answered structured questionnaires before beginning their OSCE. The major statistical analysis method employed was logistic regression. After adjustment for covariates, first-year residents were less likely than other residents to obtain high OSCE scores. The odds of high OSCE performance among interns and residents with high interaction component scores in emotional labor were significantly higher than those with low interaction scores. A high score in the interaction dimension of emotional labor was associated with strong clinical performance. The findings suggest that interventions which motivate positive attitudes and increase interpersonal interaction skills among physicians should receive higher priority.
医学教育面临着初级医师职业倦怠和情绪劳动的挑战,这对医疗质量构成了潜在威胁。尽管已有研究调查了医生的职业倦怠和情绪劳动,但缺乏关于职业倦怠、情绪劳动和临床绩效之间关联的实证研究。本研究通过实习生和住院医师的客观结构化临床考试(OSCE)成绩来研究职业倦怠和情绪劳动对临床绩效的影响。具体来说,这项横断面研究使用了马斯拉赫倦怠量表和情绪劳动问卷作为测量工具。台湾中部的 225 名实习生和住院医师在开始 OSCE 之前回答了结构化问卷。主要的统计分析方法是逻辑回归。在调整了协变量后,与其他住院医师相比,第一年住院医师获得高 OSCE 分数的可能性较小。在情绪劳动中交互成分得分较高的实习生和住院医师中,OSCE 表现良好的可能性明显高于交互得分较低的住院医师。情绪劳动的交互维度得分较高与较强的临床绩效相关。研究结果表明,应该更加重视激励医生积极态度和增加人际互动技能的干预措施。