Coleman Jamie J, Robinson Caitlin K, von Hippel William, Cohen Mitchell J
From the Department of Surgery (J.J.C.), University of Louisville School of Medicine, Louisville, Kentucky; Department of Surgery (C.K.R., M.J.C.), University of Colorado School of Medicine, Aurora, Colorado; and Research with Impact (W.v.H.), Brisbane, Australia.
J Trauma Acute Care Surg. 2025 Jun 1;98(6):880-884. doi: 10.1097/TA.0000000000004538. Epub 2025 Feb 17.
In-house call (IHC) has previously been shown to result in increased burnout in acute care surgeons (ACSs). There is wide variation, however, in the implementation and culture of work surrounding IHC across trauma centers and within the demographics of practicing ACSs. We hypothesized that local work practices and culture surrounding IHC as well as sex of ACSs would impact burnout.
Continuous physiologic data were collected over 6 months from 224 ACSs who wore a fitness wearable. Acute care surgeons were sent daily surveys to record work, personal activities, and feelings of burnout. The Maslach Burnout Inventory was completed by ACSs at the beginning and end of the study period.
Forty-eight (21.5%) of ACS reported being expected to complete the usual workday after IHC, 94 (42.2%) were expected to finish work from IHC, and 81 (36.3%) were expected to leave immediately after IHC was over. Acute care surgeons expected to complete a usual workday postcall were more likely to be burned out, and IHC resulted in a greater increase in their daily feelings of burnout than among ACSs who reported working in other work cultures. Females showed higher levels of daily burnout than males but no difference in the degree to which IHC led to burnout.
In-house call results in increased burnout in all ACSs; however, IHC had a larger impact on daily feelings of burnout in ACSs expected to work without adjustments to their work schedule postcall. Although female ACSs reported higher levels of daily burnout than male ACSs, IHC increased daily feelings of burnout equally between the two sexes. Taken together, these findings necessitate caution about work expectations surrounding IHC and suggest a need for the deliberate creation of a postcall culture for ACS.
Prognostic and Epidemiological; Level III.
此前研究表明，内部值班（IHC）会导致急诊外科医生（ACS）的职业倦怠加剧。然而，不同创伤中心以及执业ACS的人口统计学特征中，围绕IHC的工作实施和文化存在很大差异。我们推测，围绕IHC的当地工作实践和文化以及ACS的性别会影响职业倦怠。
从224名佩戴健身可穿戴设备的ACS收集了6个月的连续生理数据。每天向急诊外科医生发送调查问卷，以记录工作、个人活动和职业倦怠感。ACS在研究期开始和结束时完成了马氏职业倦怠量表。
48名（21.5%）ACS报告称预计在内部值班后完成正常工作日，94名（42.2%）预计完成内部值班工作，81名（36.3%）预计在内部值班结束后立即离开。预计在值班后完成正常工作日的急诊外科医生更容易出现职业倦怠，与报告在其他工作文化中工作的ACS相比，IHC导致他们日常职业倦怠感的增加幅度更大。女性的日常职业倦怠水平高于男性，但IHC导致职业倦怠的程度没有差异。
内部值班会导致所有ACS的职业倦怠加剧；然而，IHC对预计在值班后不调整工作日程继续工作的ACS的日常职业倦怠感影响更大。尽管女性ACS报告的日常职业倦怠水平高于男性ACS，但IHC在两性中同等程度地增加了日常职业倦怠感。综上所述，这些发现需要谨慎对待围绕IHC的工作期望，并表明需要为ACS刻意营造一种值班后文化。
预后和流行病学；三级。
