攻读儿科急诊医学 fellowship 的激励因素与障碍：急诊住院医师的横断面调查
Incentives and barriers to pursuing pediatric emergency medicine fellowship: A cross-sectional survey of emergency residents.
作者信息
Wall Jessica J, MacNeill Emily, Fox Sean M, Kou Maybelle, Ishimine Paul
机构信息
Department of Emergency Medicine University of Washington Seattle Washington USA.
Department of Pediatrics University of Washington Seattle Washington USA.
出版信息
J Am Coll Emerg Physicians Open. 2020 Nov 18;1(6):1505-1511. doi: 10.1002/emp2.12234. eCollection 2020 Dec.
BACKGROUND
Pediatric emergency physicians complete either a pediatric or emergency residency before fellowship training. Fewer emergency graduates are pursuing a pediatric emergency fellowship during the past decade, and the reasons for this decrease are unclear.
OBJECTIVES
The purpose of this study was to explore emergency residents' incentives and barriers to pursuing a fellowship in pediatric emergency medicine (PEM).
METHODS
This was a cross-sectional survey-based study. In 2016, we emailed the study survey to all Emergency Medicine Residents' Association (EMRA) members. Survey questions included respondents' interest in a PEM fellowship and perceived incentives and barriers to PEM.
RESULTS
Of 6620 EMRA members in 2016, 322 (5.0%) responded to the survey. Respondents were 59.6% male, with a mean age of 30.6 years. A total of 105 respondents (32.6%) were in their first year of emergency medicine residency, 92 (28.6%) were in their second year, 77 (23.9%) were in their third year, and 48 (14.9%) were in their fourth or fifth year. A total of 102 (31.8%) respondents planned to pursue fellowship training, whereas 120 (37.4%) were undecided. A total of 140 (43.8%) respondents reported considering a PEM fellowship at some point. Among these respondents, the most common incentives for PEM fellowship were (1) a desire to improve pediatric care in community emergency departments (86, 26.7%), (2) to develop an academic focus (54, 16.8%), and (3) because a mentor encouraged a PEM fellowship (40, 12.4%). A perceived lack of financial benefit (142, 44.1%) and length of PEM fellowship training (89, 27.6%) were the most commonly reported barriers.
CONCLUSION
In a cross-sectional survey of EMRA members, almost half of the respondents considered a PEM fellowship. PEM leaders who want to promote emergency medicine to pediatric emergency residents will need to leverage the incentives and mitigate the perceived barriers to a PEM fellowship to increase the number of emergency residency applicants.
背景
儿科急诊医师在接受专科培训前需完成儿科或急诊住院医师培训。在过去十年中，选择儿科急诊专科培训的急诊医学专业毕业生人数减少，其原因尚不清楚。
目的
本研究旨在探讨急诊住院医师选择儿科急诊医学（PEM）专科培训的动机和障碍。
方法
这是一项基于横断面调查的研究。2016年，我们通过电子邮件向所有急诊医学住院医师协会（EMRA）成员发送了研究调查问卷。调查问题包括受访者对PEM专科培训的兴趣以及对PEM的感知动机和障碍。
结果
2016年的6620名EMRA成员中，322人（5.0%）回复了调查。受访者中男性占59.6%，平均年龄为30.6岁。共有105名受访者（32.6%）处于急诊医学住院医师培训的第一年，92人（28.6%）处于第二年，77人（23.9%）处于第三年，48人（14.9%）处于第四年或第五年。共有102名受访者（31.8%）计划接受专科培训，而120人（37.4%）尚未决定。共有140名受访者（43.8%）表示在某个时候考虑过PEM专科培训。在这些受访者中，选择PEM专科培训最常见的动机是：（1）希望改善社区急诊科的儿科护理（86人，26.7%）；（2）形成学术重点（54人，16.8%）；（3）因为导师鼓励参加PEM专科培训（40人，12.4%）。最常提到的障碍是认为缺乏经济利益（142人，44.1%）和PEM专科培训时间长（89人，27.6%）。
结论
在对EMRA成员的横断面调查中，近一半的受访者考虑过PEM专科培训。想要向儿科急诊住院医师推广急诊医学的PEM领导者需要利用这些动机，并减轻对PEM专科培训的感知障碍，以增加急诊住院医师培训的申请人数量。
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