Losek J D
Children's Hospital of St. Paul, Minnesota 55102.
Pediatr Emerg Care. 1994 Oct;10(5):256-9. doi: 10.1097/00006565-199410000-00003.
The purpose of this study was to determine the characteristics of academic Pediatric Emergency Medicine (PEM) faculty, the workload of these physicians, and the perceived effect this workload has had or will have on job satisfaction. A self-administered, seven-page, closed-end survey was used. participants were PEM departments with PEM Fellowship Training Programs. Surveys were completed by 37 PEM departments (84%). The average number of faculty per department was 7.33. Ninety-three percent of the faculty were board certified in Pediatrics, Emergency Medicine, or both. Only 15% of the faculty had an academic rank of associate or full professor. Fifty-four percent of the faculty had less than five years' experience. Average patient census per department was 43,400 per year. Physicians without administrative titles averaged 30 clinician hours per week. Attending physicians covered 85 to 100% of the overnight shifts in 17 programs (52%). Clinical workload was believed to be excessive in 17 programs (46%), with total number of hours given as the most common reason for this excess. In nine of these 17 programs, excess clinical workload had resulted in physician "burnout." Physicians from only eight programs (22%) believed they could practice PEM after 50 years of age. Shift work and overnight shifts were given as the most common reason. Stressed physician groups were significantly associated with programs whose attending physicians covered > or = 85% of the night shifts (P < 0.04) and reported excessive clinical workload (P < 0.002). Job satisfaction perceived by PEM faculty appears to be dependent on addressing the clinical workload and the adverse effects of overnight and shift work.
本研究的目的是确定儿科学术急诊医学(PEM)教员的特征、这些医生的工作量,以及这种工作量对工作满意度已产生或将会产生的感知影响。采用了一份七页的封闭式自填式调查问卷。参与者为设有PEM奖学金培训项目的PEM科室。37个PEM科室(84%)完成了调查。每个科室教员的平均人数为7.33人。93%的教员拥有儿科学、急诊医学或两者的专业认证。只有15%的教员具有副教授或正教授的学术职称。54%的教员经验不足五年。每个科室每年的平均患者普查人数为43400人。没有行政职务的医生平均每周临床工作30小时。在17个项目(52%)中,主治医生承担了85%至100%的夜班工作。17个项目(46%)认为临床工作量过大,总工作时长是工作量过大的最常见原因。在这17个项目中的9个项目中,临床工作量过大导致医生出现“职业倦怠”。只有8个项目(22%)的医生认为他们50岁后仍能从事PEM工作。轮班工作和夜班工作是最常见的原因。压力大的医生群体与主治医生承担≥85%夜班工作的项目(P<0.04)以及报告临床工作量过大的项目(P<0.002)显著相关。PEM教员的工作满意度似乎取决于如何解决临床工作量以及夜班和轮班工作的不利影响。