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日本英美式急诊医学住院医师的住院医师培训经历与职业满意度

Residency and career satisfaction among Anglo-American model emergency medicine residents in Japan.

作者信息

Hagiwara Yusuke, Hasegawa Kohei, Chiba Takuyo, Watase Hiroko

机构信息

Departments of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center Tokyo Japan.

Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts.

出版信息

Acute Med Surg. 2013 Dec 16;1(1):45-53. doi: 10.1002/ams2.12. eCollection 2014 Jan.

Abstract

AIM

The number of institutions providing Anglo-American model emergency medicine has increased with the rise in its social demand in Japan. The ER Committee of the Japanese Association for Acute Medicine has introduced a residency model for use in Japanese hospitals that have adopted the Anglo-American emergency medicine model. Despite the critical importance of its quality, no studies have examined Japanese emergency medicine residents' level of satisfaction with their training. This study investigated their residency and career satisfaction, and factors associated with satisfaction.

METHODS

We developed a cross-sectional, anonymous survey. Data were obtained from 67 Anglo-American model emergency medicine residents in Japan in February 2010. Data were analyzed with factor analysis and multivariable analysis with a logistic regression model.

RESULTS

Response rate was 100% ( = 67). Overall, 50.7% and 67.2% of residents reported high residency and career satisfaction, respectively. Factor analysis derived four factors: working conditions; stress reduction; training systems; education. Logistic regression analysis revealed that the training system factor was significantly associated with high residency satisfaction (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.2-8.4) and the stress reduction factor was significantly associated with high career satisfaction (OR, 3.0; 95%CI, 1.2-8.4). A total of 28.8% reported intentions to switch specialties. The intention was not significantly associated with low residency satisfaction (OR, 1.7; 95%CI, 0.6-5.0), but was associated with low career satisfaction (OR, 5.1; 95%CI, 1.6-16.0).

CONCLUSION

Improvements in training systems and stress reduction may increase residency and career satisfaction of emergency medicine residents, respectively. This study suggested that high career satisfaction was required to secure future emergency physicians.

摘要

目的

随着日本社会对英美式急诊医学需求的增加,提供英美式急诊医学的机构数量也在上升。日本急性医学协会急诊医学委员会已引入一种住院医师培训模式,供采用英美式急诊医学模式的日本医院使用。尽管培训质量至关重要,但尚无研究调查日本急诊医学住院医师对培训的满意度。本研究调查了他们对住院医师培训和职业的满意度以及与满意度相关的因素。

方法

我们开展了一项横断面匿名调查。2010年2月从日本67名英美式急诊医学住院医师处获取数据。采用因子分析和逻辑回归模型进行多变量分析。

结果

回复率为100%(n = 67)。总体而言,分别有50.7%和67.2%的住院医师表示对住院医师培训和职业高度满意。因子分析得出四个因子:工作条件;减压;培训系统;教育。逻辑回归分析显示,培训系统因子与住院医师培训高度满意度显著相关(优势比[OR],2.9;95%置信区间[CI],1.2 - 8.4),减压因子与职业高度满意度显著相关(OR,3.0;95%CI,1.2 - 8.4)。共有28.8%的人表示有转专业的意向。该意向与住院医师培训低满意度无显著关联(OR,1.7;95%CI,0.6 - 5.0),但与职业低满意度相关(OR,5.1;95%CI,1.6 - 16.0)。

结论

培训系统的改进和减压措施可能分别提高急诊医学住院医师对住院医师培训和职业的满意度。本研究表明,要留住未来的急诊医生需要较高的职业满意度。

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