Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMJ Open. 2022 Jan 11;12(1):e053280. doi: 10.1136/bmjopen-2021-053280.
To determine whether experiences of off-the-job training in domestic (DT) and overseas study (OS) settings are associated with work performance and work-family conflict in physicians.
DESIGN, SETTING AND PARTICIPANTS: We conducted a national cross-sectional survey in 77 public hospitals across seven provinces in China between July 2014 and April 2015. Participants were 3182 physicians.
Participants were categorised into four groups: none, DT only, OS only and DT and OS.
Work performance was assessed by work engagement, career attrition and patient-centred care. Work-family conflict was assessed by affecting care for family, feeling guilty towards family and receiving complaints from family.
A total of 25.89% participants had experienced DT only, 8.71% OS only and 8.47% DT and OS. After adjustment for potential confounders, participants who had experiences of DT and OS compared with those with no training were more likely to report positive work performance (pride in work: OR=2.11, 95% CI: 1.43 to 3.10; enjoyment of work: OR=1.67, 95% CI: 1.11 to 2.51; turnover intention: OR=0.54, 95% CI: 0.38 to 0.77; early retirement: OR=0.63, 95% CI: 0.45 to 0.89; and exhaustion: OR=0.66, 95% CI: 0.45 to 0.98) and less work-family conflicts (feeling guilty towards family: OR=0.51, 95% CI: 0.35 to 0.74; and complaints from family: OR=0.66, 95% CI: 0.47 to 0.91). We found no obvious association between DT/OS experience with patient-centred care.
Physicians with DT and OS experiences are more likely to have better work performance and less work-family conflict than those without such experience. Physicians face increasing pressure to pursue continuing education and experience associated distress. Therefore, hospitals and government policy-makers should promote DT and OS.
确定国内（DT）和海外学习（OS）环境中的在职培训经历是否与医生的工作表现和工作家庭冲突有关。
设计、地点和参与者：我们于 2014 年 7 月至 2015 年 4 月在中国七个省的 77 家公立医院进行了一项全国性的横断面调查。参与者为 3182 名医生。
参与者分为四组：无、仅 DT、仅 OS 和 DT 和 OS。
工作表现通过工作投入、职业流失和以患者为中心的护理来评估。工作家庭冲突通过影响对家庭的照顾、对家庭的内疚感和来自家庭的投诉来评估。
共有 25.89%的参与者仅经历过 DT，8.71%的参与者仅经历过 OS，8.47%的参与者同时经历过 DT 和 OS。在调整潜在混杂因素后，与无培训相比，有 DT 和 OS 经历的参与者更有可能报告积极的工作表现（工作自豪感：OR=2.11，95%CI：1.43 至 3.10；工作享受：OR=1.67，95%CI：1.11 至 2.51；离职意向：OR=0.54，95%CI：0.38 至 0.77；提前退休：OR=0.63，95%CI：0.45 至 0.89；和精疲力竭：OR=0.66，95%CI：0.45 至 0.98）和较少的工作家庭冲突（对家庭的内疚感：OR=0.51，95%CI：0.35 至 0.74；和来自家庭的投诉：OR=0.66，95%CI：0.47 至 0.91）。我们没有发现 DT/OS 经历与以患者为中心的护理之间有明显的关联。
与没有此类经历的医生相比，有 DT 和 OS 经历的医生更有可能表现出更好的工作表现和较少的工作家庭冲突。医生面临着越来越大的继续教育和相关压力的压力。因此，医院和政府政策制定者应促进 DT 和 OS。
