Department of Emergency Medicine, International University of Health and Welfare Tokyo, Otawara, Japan.
Nakashima Clinic, Minato City, Tokyo, Japan.
PLoS One. 2020 Mar 11;15(3):e0230186. doi: 10.1371/journal.pone.0230186. eCollection 2020.
Professionalism is a critical competency for emergency medicine (EM) physicians, and professional behavior affects patient satisfaction. However, the findings of various studies indicate that there are differences in the interpretation of professionalism among EM resident physicians and faculty physicians. Using a cross-sectional survey, we aimed to analyze common challenges to medical professionalism for Japanese EM physicians and survey the extent of professionalism coursework completed during undergraduate medical education. We conducted a multicenter cross-sectional survey of EM resident physicians and faculty physicians at academic conferences and eight teaching hospitals in Japan using the questionnaire by Barry and colleagues. We analyzed the frequency of providing either the best or second-best answers to each scenario as the main outcome measure and compared the frequencies between EM resident physicians and EM faculty physicians. Fisher's exact test and the Wilcoxon rank sum test were used to analyze data. A total of 176 physicians (86 EM resident physicians and 90 EM faculty physicians) completed the survey. The response rate was 92.6%. The most challenging scenario presented to participants dealt with sexual harassment, and only 44.5% chose the best or second-best answers, followed by poor responses to the confidentiality scenario (69.9%). The frequency of either the best or second-best responses to the confidentiality scenario was significantly greater for EM resident physicians than for EM faculty physicians (77.1% versus 62.9%, p = 0.048). More participants in the EM resident physician group completed formal courses in medical professionalism than those in the EM faculty physician group (25.8% versus 5.5%, p < 0.01). Further, EM faculty physicians were less likely than EM resident physicians to provide acceptable responses in terms of confidentiality, and few of both had received professionalism training through school curricula. Continuous professionalism education focused on the prevention of sexual harassment and gender gap is needed for both EM resident physicians and faculty physicians in Japan.
专业性是急诊医学（EM）医师的关键能力，专业行为会影响患者满意度。然而，各种研究的结果表明，急诊住院医师和住院医师之间对专业性的理解存在差异。我们使用横断面调查，旨在分析日本急诊医师在医学专业性方面面临的常见挑战，并调查本科医学教育期间完成的专业性课程的程度。我们在日本的学术会议和八所教学医院对急诊住院医师和住院医师进行了多中心横断面调查，使用了 Barry 等人的问卷。我们分析了对每个场景提供最佳或第二佳答案的频率作为主要结果指标，并比较了急诊住院医师和急诊住院医师之间的频率。Fisher 精确检验和 Wilcoxon 秩和检验用于分析数据。共有 176 名医师（86 名急诊住院医师和 90 名急诊住院医师）完成了调查。应答率为 92.6%。向参与者提出的最具挑战性的场景涉及性骚扰，只有 44.5%选择了最佳或第二佳答案，其次是对保密性场景的反应不佳（69.9%）。在急诊住院医师组中，对保密性场景的最佳或第二佳反应的频率明显高于急诊住院医师组（77.1%比 62.9%，p = 0.048）。在急诊住院医师组中，完成医学专业性正规课程的参与者多于在急诊住院医师组中的参与者（25.8%比 5.5%，p < 0.01）。此外，与急诊住院医师相比，急诊住院医师在保密性方面提供可接受的反应的可能性较小，而且两者都很少通过学校课程接受专业性培训。日本的急诊住院医师和住院医师都需要接受以预防性骚扰和性别差距为重点的持续专业性教育。
