Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea.
PLoS One. 2024 Apr 11;19(4):e0301502. doi: 10.1371/journal.pone.0301502. eCollection 2024.
Duty hour regulations (DHRs) were enforced in 2017 in Korea to prevent the detrimental effects of excessively prolonged working hours among medical residents. We investigated the adoption of and implications of the new DHRs among medical residents and faculty members. Semi-structured interviews were conducted with 15 medical residents and 9 faculty members across general surgery, internal medicine, obstetrics-gynecology, and pediatrics departments at Chonnam National University Hospital. Based on the constructivist grounded theory, we developed themes from the data by concurrent coding and analysis with theoretical sampling until data saturation. In addition, respondent validation was used to ensure accuracy, and all authors remained reflexive throughout the study to improve validity. The methods of DHRs adoption among residents and faculty members included the following 4 themes: DHRs improved work schedule, residents have more time to learn on their own, clinical departments have come to distribute work, organization members have strived to improve patient safety. Residents have undertaken initial steps towards creating a balance between personal life and work. Teamwork and shift within the same team are the transitions that minimize discontinuity of patient care considering patient safety. Teaching hospitals, including faculty members, should ensure that residents' work and education are balanced with appropriate clinical experience and competency-based training.
2017 年韩国实施了工作时间规定(DHRs),以防止住院医师过度延长工作时间带来的不利影响。我们调查了新的 DHRs 在住院医师和教师中的采用情况及其影响。我们在全南国立大学医院的普通外科、内科、妇产科和儿科部门对 15 名住院医师和 9 名教师进行了半结构化访谈。基于建构主义扎根理论,我们通过同时编码和理论抽样分析从数据中开发主题,直到数据饱和。此外,还使用了受访者验证来确保准确性,并且所有作者在整个研究过程中都保持反思,以提高有效性。住院医师和教师采用 DHRs 的方法包括以下 4 个主题:DHRs 改善了工作时间表,住院医师有更多时间自学,临床科室开始分配工作,组织成员努力提高患者安全。住院医师已经在个人生活和工作之间取得平衡方面迈出了第一步。考虑到患者安全,团队合作和同一团队内的轮班是最大限度减少患者护理连续性中断的转变。包括教师在内的教学医院应确保住院医师的工作和教育与适当的临床经验和基于能力的培训相平衡。
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