Wood V C, Markert R J, McGlynn T J
Miami Valley Hospital, Dayton, OH.
Acad Med. 1993 Aug;68(8):640-2. doi: 10.1097/00001888-199308000-00017.
To quantify the workload of residents on night call and to determine the residents' perceptions of the balance between service and education in their night-call activities.
Twenty-two internal medicine residents--nine first-year residents and 13 senior residents (i.e., in their second, third, or fourth year)--kept logs of their night-call activities for two periods of 16 days each in 1991-92, at a 772-bed teaching hospital affiliated with Wright State University School of Medicine. The residents used the following five-point scale to rate each activity: 1, strictly service; 3, even balance; 5, strictly education. They also recorded the total times spent on various activities. Data were analyzed by using the independent and paired t-tests.
Ninety-eight percent of the logs were returned. The first-year and senior residents did not differ significantly in times spent on logged events. Both the first-year and the senior residents perceived many night-call activities to be weighted toward education, especially those involving evaluation of acutely ill patients being considered for hospital admission (overall mean rating of 3.3). There was no striking difference between the first-year and senior residents' perceptions of the balance between service and education in their activities.
The residents' perceptions of the relationship between service and education indicate that there was an even balance between the two. The educational aspects of night-call duties can and should remain an integral part of residents' training.
量化住院医师夜间值班的工作量,并确定住院医师对其夜间值班活动中服务与教育平衡的看法。
1991 - 1992年期间,在赖特州立大学医学院附属的一家拥有772张床位的教学医院,22名内科住院医师(9名一年级住院医师和13名高年级住院医师,即二年级、三年级或四年级住院医师)对他们的夜间值班活动进行了两次记录,每次记录为期16天。住院医师使用以下五分制对每项活动进行评分:1分表示严格为服务;3分表示平衡;5分表示严格为教育。他们还记录了在各项活动上花费的总时间。数据采用独立样本t检验和配对t检验进行分析。
98%的记录被返还。一年级和高年级住院医师在记录事件上花费的时间没有显著差异。一年级和高年级住院医师都认为许多夜间值班活动偏向于教育,尤其是那些涉及对考虑入院的急性病患者进行评估的活动(总体平均评分为3.3)。一年级和高年级住院医师对其活动中服务与教育平衡的看法没有显著差异。
住院医师对服务与教育关系的看法表明两者之间达到了平衡。夜间值班职责的教育方面能够而且应该仍然是住院医师培训的一个组成部分。