Kozlowska K, Nunn K, Cousens P
Arndell Children's Unit, Royal North Shore Hospital, North Ryde, New South Wales, Australia.
Aust N Z J Psychiatry. 1997 Oct;31(5):641-52; discussion 653-4. doi: 10.3109/00048679709062676.
To examine the perceptions of New South Wales (NSW) psychiatric trainees in relation to their training, the adverse events they experienced and the role and quality of the consultant-registrar relationship.
A self-report questionnaire was developed to probe trainee perceptions of the consultant-trainee relationship and adverse events during training in all those who had completed at least 1 year of training in psychiatry (n = 138) in NSW, as well as all consultants who had completed their training in the last 5 years (n = 95). All subjects were asked to rate the frequency and relative impact of 20 adverse experiences with the opportunity to proffer adversities not listed. They were also asked to rate their experience of their consultants in relation to the adversity.
The results from The Training Impact Study exploring adverse events experienced by NSW trainees are presented. Assault by a patient and suicide of a patient are identified as the most stressfull adversities of training in psychiatry. However, more general concerns such as educational and emotional neglect by supervisors, observing consultant maltreatment of patients, exam failure and conflict between consultants were also identified and discussed.
The high response rate of both trainees and consultants gives these results a level of representative validity. Recommendations in relation to future training and research are put forward. Specific training in the management of potentially assaultive patients and facilitating trainee recovery from assault or threat of assault should be a priority of the Royal Australian and New Zealand College of Psychiatrists. Support and education in relation to patient suicide is also important. Training and recognition of teachers within the College should be encouraged.
研究新南威尔士州（NSW）精神科实习医生对其培训、所经历的不良事件以及会诊医生与实习医生关系的作用和质量的看法。
设计了一份自填式问卷，以探究所有在NSW完成至少1年精神科培训的实习医生（n = 138）以及所有在过去5年完成培训的会诊医生（n = 95）对会诊医生与实习医生关系及培训期间不良事件的看法。所有受试者被要求对20种不良经历的发生频率和相对影响进行评分，并有机会提出未列出的不良事件。他们还被要求对会诊医生在这些不良事件方面的表现进行评分。
呈现了培训影响研究中有关NSW实习医生所经历不良事件的结果。患者的攻击行为和患者自杀被确定为精神科培训中最具压力的不良事件。然而，也发现并讨论了一些更普遍的问题，如上级的教育和情感忽视、目睹会诊医生虐待患者、考试失败以及会诊医生之间的冲突。
实习医生和会诊医生较高的回应率使这些结果具有一定程度的代表性效度。提出了有关未来培训和研究的建议。针对潜在攻击性患者的管理以及帮助实习医生从攻击或攻击威胁中恢复的具体培训应成为澳大利亚和新西兰皇家精神科医学院的优先事项。有关患者自杀的支持和教育也很重要。应鼓励学院内部对教师进行培训和认可。
