Virginia Commonwealth University, School of Medicine Dean's Office, Richmond, Virginia.
Virginia Commonwealth University, Department of Surgery, Richmond, Virginia.
J Surg Res. 2019 Feb;234:20-25. doi: 10.1016/j.jss.2018.08.035. Epub 2018 Sep 27.
Surgical residents train under immense stress, often manifesting into poor well-being. While recent research identifies methods of coping with stress, few studies empirically investigate the role of the environment on surgical resident well-being. We aimed to assess surgical resident perceptions of workplace climate, organizational support, burnout, and job satisfaction to test a mediation model identifying antecedents to well-being.
A convenience sampling of program directors from general surgery within the Eastern region of the United States were emailed to request either agenda time to collection data via paper survey or to forward an electronic survey link to their residents between March 2016 and June 2016. The survey included scales demonstrating validity evidence on well-being, climate, and perceptions of support.
Based on 160 general surgery residents (out of 557; 29% response rate) across 19 training programs, our mediation model found that job satisfaction was significantly predicted by workplace climate directly (direct effect = 0.37, 95% CI [0.19, 0.55]) and indirectly (specific indirect effect = 0.07, 95% CI [0.01, 0.13]) through perceived organizational support and burnout, while controlling for training year and gender, F(5,147) = 53.76, P < 0.001, Rsq. = 0.65.
Medical education requires an additional focus on how the clinical learning environment affects surgical resident well-being. Health systems and training programs will need to collaborate on workplace innovations to improve workplace climate for trainees to address the concerns of well-being with a modern surgical workforce.
外科住院医师在巨大的压力下接受培训，往往表现出较差的健康状况。虽然最近的研究确定了应对压力的方法，但很少有研究从实证角度探讨环境对外科住院医师健康的影响。我们旨在评估外科住院医师对工作场所氛围、组织支持、倦怠和工作满意度的看法，以测试一个中介模型，该模型确定了幸福感的前置因素。
通过电子邮件向美国东部地区普通外科项目主任发送了便利抽样调查，要求他们在 2016 年 3 月至 2016 年 6 月期间，要么安排时间通过纸质调查收集数据，要么向住院医师转发电子调查链接。该调查包括了证明幸福感、气候和支持感方面有效性证据的量表。
基于 19 个培训项目的 160 名普通外科住院医师（557 名中的 29%，回应率），我们的中介模型发现，工作满意度直接通过工作场所氛围显著预测（直接效应=0.37，95%置信区间[0.19，0.55]）和间接预测（通过感知组织支持和倦怠的特定间接效应=0.07，95%置信区间[0.01，0.13]），同时控制了培训年限和性别，F(5,147)=53.76，P<0.001，Rsq.=0.65。
医学教育需要进一步关注临床学习环境如何影响外科住院医师的健康。卫生系统和培训计划将需要合作进行工作场所创新，以改善受训者的工作场所氛围，解决现代外科劳动力的健康问题。
