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导致巴基斯坦妇科住院医师职业行为失误的因素:一项通过患者和家属、顾问和住院医师的视角反映的研究。

Factors leading to lapses in professional behaviour of Gynae residents in Pakistan: a study reflecting through the lenses of patients and family, consultants and residents.

机构信息

Department of Obstetrics &Gynaecology, Rawalpindi Medical University, Rawalpindi, Pakistan.

Department of Medical Education, Riphah International University, Islamabad, Pakistan.

出版信息

BMC Med Educ. 2024 Jun 3;24(1):611. doi: 10.1186/s12909-024-05509-9.


DOI:10.1186/s12909-024-05509-9
PMID:38831320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11149338/
Abstract

INTRODUCTION: Professional behaviour is the first manifestation of professionalism. In teaching hospitals, the residents can be considered vulnerable to lapses in professional behaviour when they fail to meet the set standards of professionalism. Residents of some specialties are more at risk of lapses in professional behaviour due to the demanding nature of work. Research focusing on the behaviour of residents in the field of Gynae and the underlying factors contributing to such behaviour is notably lacking in the literature. Additionally, there is a gap in understanding the perspectives of patients from Pakistan on this matter, as it remains unexplored thus far, which constitutes the central focus of this study. An increase in complaints lodged against Gynae resident's professional behaviour in Pakistan Citizen Portal (PCP) was observed. Therefore, an exploratory qualitative study was conducted to investigate the factors and rationales contributing to the lapses in resident's professional behaviour. The study collected the viewpoints of three stakeholder groups: patients and their families, consultants and residents. The study was conducted in three phases. First, the document analysis of written complaints was conducted, followed by face-to-face interviews (11 per group) conducted by trained researchers from an independent 3rd party. Finally, the interview data was transcribed, coded and analysed. In total 15 themes were identified from the interviews with 3 stakeholders, which were then categorized and resulted in 6 overlapping themes. The most prevalent lapse reported by all 3 stakeholders was poor verbal behaviour of residents. CONCLUSION: The highly ranked factors contributing to triggering the situation were associated with workplace challenges, well-being of residents, limited resources, patients and family characteristics, patients' expectations, lack of administrative and paramedic support, cultural factors and challenges specific to Gynae specialty. Another intriguing and emerging theme was related to the characteristics of patients and attendants which helped in understanding the causes and implications of conflicting environments. The value of competency also emphasized that can be accomplished by training and mentoring systems. The thorough examination of these factors by key stakeholders aided in accurately analysing the issue, its causes, and possible solutions. The study's findings will assist higher authorities in implementing corrective actions and offering evidence-based guidance to policymakers to improve healthcare system.

摘要

简介:职业行为是专业性的首要表现。在教学医院,当住院医师未能达到既定的职业行为标准时,他们可能会表现出职业行为的失误。由于工作性质的要求,某些专业的住院医师更容易出现职业行为失误。尽管如此,目前文献中缺乏对妇科住院医师行为及其促成因素的研究。此外,由于这方面的研究在巴基斯坦尚未开展,因此,人们对患者的观点也缺乏了解,这是本研究的核心关注点。巴基斯坦公民门户网站(PCP)收到了越来越多针对妇科住院医师职业行为的投诉。因此,本研究采用探索性定性方法,旨在调查导致住院医师职业行为失误的因素和原因。研究收集了三个利益相关者群体的观点:患者及其家属、顾问和住院医师。研究分三个阶段进行。首先,对书面投诉进行了文件分析,然后由独立第三方的培训研究人员进行了 11 组面对面访谈。最后,对访谈数据进行了转录、编码和分析。从三个利益相关者的访谈中共确定了 15 个主题,然后对这些主题进行分类,最终得出 6 个重叠主题。所有三个利益相关者报告的最常见失误是住院医师的言语不当。 结论:触发这种情况的高排名因素与工作场所挑战、住院医师的健康、资源有限、患者和家属特征、患者期望、行政和辅助支持缺乏、文化因素以及妇科专业特定挑战有关。另一个有趣且新兴的主题与患者和陪护人员的特征有关,这有助于理解冲突环境的原因和影响。能力的价值也通过培训和指导系统得到了强调。通过主要利益相关者对这些因素的深入检查,有助于准确分析问题、其原因和可能的解决方案。研究结果将帮助上级主管部门采取纠正措施,并为政策制定者提供循证指导,以改善医疗保健系统。

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Factors leading to lapses in professional behaviour of Gynae residents in Pakistan: a study reflecting through the lenses of patients and family, consultants and residents.

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本文引用的文献

[1]
Unprofessional behaviour of GP residents leading to a dismissal dispute: characteristics and outcomes of those who appeal.

BMC Prim Care. 2024-2-20

[2]
Unprofessional behaviour of GP residents and its remediation: a qualitative study among supervisors and faculty.

BMC Fam Pract. 2021-12-20

[3]
A narrative study on work place based conflicts in Obstetrics and Gynaecology Department.

J Pak Med Assoc. 2021-2

[4]
Personal factors affecting medical professionalism: a qualitative study in Iran.

J Med Ethics Hist Med. 2020-5-5

[5]
Understanding Unprofessionalism in Residents.

J Grad Med Educ. 2020-6

[6]
Unprofessional behaviour of junior doctors: a retrospective analysis of outcomes by the Singapore Medical Council disciplinary tribunals.

Singapore Med J. 2021-3

[7]
Do Professionalism Lapses in Medical School Predict Problems in Residency and Clinical Practice?

Acad Med. 2020-6

[8]
How to identify, address and report students' unprofessional behaviour in medical school.

Med Teach. 2020-4

[9]
Obstacles of professional behavior among medical trainees: A qualitative study from Iran (2018).

J Educ Health Promot. 2019-10-24

[10]
Understanding and Remediating Lapses in Professionalism: Lessons From the Island of Last Resort.

Ann Thorac Surg. 2019-8-31

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