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工作重塑以坚持外科培训:从住院医师角度的定性研究。

Job Crafting to Persist in Surgical Training: A Qualitative Study From the Resident's Perspective.

机构信息

Department of Surgery, Universidad de la Sabana, Chía, Colombia.

Department of Educational Development and Research, School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.

出版信息

J Surg Res. 2019 Jul;239:180-190. doi: 10.1016/j.jss.2019.02.005. Epub 2019 Mar 4.

Abstract

BACKGROUND

Attrition in surgical training, a result of poor well-being at work, continues to rise. Work engagement and persistence, the other side of the coin, depend on the proactivity of residents to optimize the demands and resources in the workplace to achieve a better fit with the environment. This type of proactivity refers to job-crafting. In this study, we sought to explore the specific mechanisms underlying residents' job-crafting to enhance work engagement and persistence, as well as the role of supervisors in this endeavor.

MATERIALS AND METHODS

We used a constructivist-grounded theory design. We conducted semistructured interviews of active residents. During the analysis of verbatim protocols, we developed codes and categories and identified the main themes (job-crafting mechanisms) related to work engagement and persistence. We anticipated procedures to engage in reflexivity.

RESULTS

The residents showed six job-crafting mechanisms (build trust with supervisors, manage proactively, seek help, see errors and frustrations as learning opportunities, find a suitable work-life balance, and seek challenges actively). The supervisors contributed to residents' job-crafting with four mechanisms (earning the trust of the residents, providing guidance and support, allowing residents to fulfill tasks befitting a surgeon in training, and offering increasingly challenging tasks to residents).

CONCLUSIONS

Work engagement and persistence in training are active processes that depend on the ability of residents to take advantage of resources and challenges and to diminish hindering demands at the workplace. Future research should focus on the perspectives of the supervisor, as well as on the effectiveness of job-crafting interventions, to enhance work engagement.

摘要

背景

工作幸福感不佳导致外科培训中的人员流失持续增加。工作投入和坚持是另一面,取决于住院医师的积极性,以优化工作场所的需求和资源,从而更好地适应环境。这种积极性被称为工作重塑。在这项研究中,我们试图探讨住院医师工作重塑的具体机制,以提高工作投入和坚持度,以及主管在这方面的作用。

材料与方法

我们采用了建构主义-扎根理论设计。我们对积极的住院医师进行了半结构化访谈。在对逐字记录的协议进行分析时,我们开发了代码和类别,并确定了与工作投入和坚持度相关的主要主题(工作重塑机制)。我们预计会进行反思性程序。

结果

住院医师表现出六种工作重塑机制(与主管建立信任、主动管理、寻求帮助、将错误和挫折视为学习机会、找到合适的工作-生活平衡、主动寻求挑战)。主管通过四种机制促进住院医师的工作重塑(赢得住院医师的信任、提供指导和支持、允许住院医师完成适合培训外科医生的任务、为住院医师提供越来越具有挑战性的任务)。

结论

培训中的工作投入和坚持是积极的过程,取决于住院医师利用资源和挑战以及减少工作场所阻碍性需求的能力。未来的研究应关注主管的观点,以及工作重塑干预措施的有效性,以提高工作投入度。

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