Baylor College of Medicine, Department of Emergency Medicine, USA.
Baylor College of Medicine, Department of Emergency Medicine, USA; Baylor College of Medicine, Department of Internal Medicine, USA.
Am J Emerg Med. 2022 Jun;56:310-311. doi: 10.1016/j.ajem.2021.08.020. Epub 2021 Aug 21.
As part of an institutional effort to develop an atmosphere of communication and encourage mutual appreciation of respective viewpoints, we used a cross-sectional survey to investigate the perceptions of emergency (EM) and internal medicine (IM) residents and faculty, particularly, their attitudes about collaboration, mutual respect, and mistreatment. This cross-sectional survey was administered to the EM and IM faculty and residents of a county, academic hospital with a Level 1 Trauma Center to evaluate each specialty's current perception of professional behavior and observations of unprofessional behavior in order to identify areas for improvement. The survey items were answered using a 5-point Likert scale and was analyzed using the unpaired t-test. A total of 68 residents and faculty completed the survey, 32 (59.4% residents) from EM and 36 (94.4% residents) from IM. Among all EM and IM clinicians, 48.6% felt that there was a culture of clinical collaboration. Approximately half of the respondents (51.5%) felt that the state of professionalism between the two departments was below that of other departments. About 10% (11.8%) of all respondents reported experiencing unprofessional behaviors from the other department at least once a month. Challenges identified by EM faculty and residents included time to consult, recommendations, and disposition. Challenges identified by IM included difficulty contacting EM providers and lack of communication regarding patient's clinical status changes. Both specialties emphasized the importance of improved patient care transitional processes. This study is an important first look at the prevalence of negative attitudes and misperceptions between EM and IM providers. These perspectives can occur due to breakdown of communication and differing expectations. Such asynchronies can cause a toxic workplace environment, diminished performance, and poor patient outcomes.
作为机构努力营造沟通氛围和鼓励相互欣赏各自观点的一部分,我们使用横断面调查来调查急诊(EM)和内科(IM)住院医师和教师的看法,特别是他们对合作、相互尊重和虐待的态度。这项横断面调查是针对一家县级学术医院的 EM 和 IM 教师和住院医师进行的,该医院设有一级创伤中心,旨在评估每个专业对当前专业行为的看法以及对不专业行为的观察,以确定需要改进的领域。调查项目使用 5 分李克特量表回答,并使用配对 t 检验进行分析。共有 68 名住院医师和教师完成了调查,其中 32 名(59.4%的住院医师)来自 EM,36 名(94.4%的住院医师)来自 IM。在所有 EM 和 IM 临床医生中,有 48.6%的人认为存在临床合作文化。大约一半的受访者(51.5%)认为这两个部门的专业精神状况不如其他部门。约 10%(11.8%)的受访者报告说,他们至少每月都会受到来自其他部门的不专业行为。EM 教师和住院医师提出的挑战包括咨询时间、建议和处置。IM 提出的挑战包括难以联系到 EM 提供者以及缺乏关于患者临床状况变化的沟通。两个专业都强调了改进患者护理过渡流程的重要性。这项研究首次重要地探讨了 EM 和 IM 提供者之间存在消极态度和误解的普遍性。这些观点可能是由于沟通中断和期望不同而产生的。这种异步会导致工作环境有毒、绩效下降和患者预后不佳。