Orthopedic Surgery Division, Rambam Health Care Campus, Haifa, Israel.
Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Isr J Health Policy Res. 2022 Feb 10;11(1):11. doi: 10.1186/s13584-022-00521-0.
Specialization in medical professions is considered a challenging and intensive period due to the number and sequence of duty hours. Considering the effect of duty hours on residents, both physically and mentally, several models have been created over the years to address this complexity. The two main model schools aim to decrease the duty hour length and night shift (i.e., night float, NF) frequency. In recent years, duty hours have become a source of disagreement and frustration among the medical community, both residents and attendings. A possible change in the duty hour structure may affect residents in terms of several parameters, such as patient safety, the well-being of the physician and the degree of training of the resident.
(1) To investigate medical residents' perspectives on their duty hours utilizing online questionnaires on their effect on the work environment and (2) to assess residents' preferences in relation to the suggested shortened shift and NF models.
Questionnaires were emailed to all residents (main residents and fellows) at an Israeli tertiary medical center between March 2020 and April 2020. Questions were scored from 1 (disagree) to 5 (fully agree).
Two hundred and sixty residents (227 main residents, 43 fellows) participated in the study (40% female). The score for the degree of balance between work and personal life was low (0.9±1.99). The shortened shift model was perceived by the residents as more compatible with a balanced lifestyle than the NF model (3.77 ± 1.20 and 3.14 ± 1.26, respectively, P < 0.0001). Neither model was considered to risk impairing professional training (2.33 ± 1.45 and 2.47 ± 1.25, respectively, P = 0.12). Overall, 74% of the residents were not willing to lower their income if the decision were made to change models, and 56% were not willing to increase the number of shifts.
There is agreement among residents that shortening shift hours to 16 h would have a positive effect on the balance between personal life and work. In the eyes of residents, the change would not impair their training during residency.
由于值班时间的数量和顺序，医学专业的专业化被认为是一个具有挑战性和密集的时期。考虑到值班时间对住院医师身心的影响，多年来已经创建了几种模式来解决这种复杂性。这两个主要的模式学派旨在减少值班时间的长度和夜班（即夜间轮班，NF）的频率。近年来，值班时间已经成为医学界住院医师和主治医生之间分歧和沮丧的一个来源。值班时间结构的可能变化可能会影响住院医师的几个参数，例如患者安全、医生的健康状况和住院医师的培训程度。
（1）利用在线问卷调查住院医师对值班时间的看法，调查其对工作环境的影响；（2）评估住院医师对缩短轮班和 NF 模式的偏好。
2020 年 3 月至 4 月期间，向以色列一家三级医疗中心的所有住院医师（主要住院医师和研究员）发送了在线问卷。问题的评分从 1（不同意）到 5（完全同意）。
260 名住院医师（227 名主要住院医师，43 名研究员）参与了这项研究（40%为女性）。工作与个人生活之间平衡程度的评分较低（0.9±1.99）。与 NF 模式相比，缩短轮班模式被住院医师认为更能与平衡的生活方式相兼容（分别为 3.77 ± 1.20 和 3.14 ± 1.26，P < 0.0001）。两种模式都被认为不会损害专业培训（分别为 2.33 ± 1.45 和 2.47 ± 1.25，P = 0.12）。总体而言，如果决定改变模式，74%的住院医师不愿意降低收入，56%的住院医师不愿意增加轮班次数。
住院医师一致认为将轮班时间缩短至 16 小时将对个人生活和工作之间的平衡产生积极影响。在住院医师看来，这种变化不会损害他们在住院医师期间的培训。
