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Soto-Moreno A, Ureña-Paniego C, Montero-Vílchez T, Sánchez-Díaz M, Díaz-Calvillo P, Rodríguez-Pozo JA, Molina-Leyva A, Martínez-López A, Buendía-Eisman A, Arias-Santiago S. Quality of Professional Life Among Dermatologists: Impact of the COVID-19 Pandemic and Suggestions for Improvement. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:231-236. [PMID: 37884261 DOI: 10.1016/j.ad.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. MATERIAL AND METHODS We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). RESULTS We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P=.02 and P=.005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. CONCLUSIONS Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.
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Affiliation(s)
- A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - T Montero-Vílchez
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - P Díaz-Calvillo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - J A Rodríguez-Pozo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - A Martínez-López
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España.
| | - A Buendía-Eisman
- Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
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Soto-Moreno A, Ureña-Paniego C, Montero-Vílchez T, Sánchez-Díaz M, Díaz-Calvillo P, Rodríguez-Pozo JA, Molina-Leyva A, Martínez-López A, Buendía-Eisman A, Arias-Santiago S. [Translated article] Quality of Professional Life Among Dermatologists: Impact of the COVID-19 Pandemic and Suggestions for Improvement. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T231-T236. [PMID: 38242430 DOI: 10.1016/j.ad.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/09/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. MATERIAL AND METHODS We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). RESULTS We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P=.02 and P=.005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. CONCLUSIONS Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.
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Affiliation(s)
- A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - T Montero-Vílchez
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - P Díaz-Calvillo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - J A Rodríguez-Pozo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
| | - A Buendía-Eisman
- Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Soto-Moreno A, Martínez-López A, Ureña-Paniego C, Martínez-García E, Buendía-Eisman A, Arias-Santiago S. Burnout Syndrome, Anxiety, and Depression in Dermatology Residents: A Cross-Sectional Study. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00157-1. [PMID: 38382752 DOI: 10.1016/j.ad.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Burnout syndrome is a mental health disorder due to chronic occupational stress. Both burnout and associated comorbidities are prevalent among health care professionals, being medical residents a vulnerable group. Despite this, the scientific medical literature currently available on this issue in dermatology residents is scarce. The aim of this study was to analyze the prevalence of the burnout syndrome, anxiety, and depression in dermatology residents, and the associated risk factors. MATERIAL AND METHOD This was a cross-sectional trial designed to include dermatology residents from Spain (from December 2022 through June 2023). A self-administered form was sent via online messaging applications, including validated scales to study professional quality of life, burnout syndrome, anxiety, and depression. RESULTS A total of 48 dermatology residents were included in the study, 50% of whom (24/48) were women, with a mean age of 27 years (1.25). A total of 58.33% (28/48) of the residents had some degree of anxiety, 22.9% (11/48) some degree of depression, and 23.4% a moderate risk of burnout (11/48). Workload was the main risk factor associated with the 3 disorders studied, while managerial support or intrinsic motivation seem to play a protective role. CONCLUSIONS Burnout syndrome and its comorbidities are both prevalent in dermatology residents in Spain and closely related to each other.
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Affiliation(s)
- A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - A Martínez-López
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España; Grupo de Epidemiología y Promoción de la Salud en Dermatología, Asociación Española de Dermatología y Venereología, Madrid, España.
| | - C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - E Martínez-García
- Grupo de Epidemiología y Promoción de la Salud en Dermatología, Asociación Española de Dermatología y Venereología, Madrid, España
| | - A Buendía-Eisman
- Grupo de Epidemiología y Promoción de la Salud en Dermatología, Asociación Española de Dermatología y Venereología, Madrid, España; Departamento de Dermatología, Facultad de Medicina, Universidad de Granada, Granada, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España; Departamento de Dermatología, Facultad de Medicina, Universidad de Granada, Granada, España; TECe19-Dermatología Clínica y Traslacional, Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, Granada, España
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Burnet G, Platnick C, Krishnan P, Robinson CK, Sauaia A, Burlew CC, Nehler MR, Jaiswal K, Platnick KB. Muffins and Meditation: Combatting Burnout in Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2023; 80:185-193. [PMID: 36184410 DOI: 10.1016/j.jsurg.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/19/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To quantify the prevalence of burnout in our surgical residency program and to assess the impact of a weekly wellness program for surgical residents through validated tools measuring mindfulness, self-compassion, flourishing, and burnout. Our hypothesis was that participants with more frequent attendance would: (1) be more mindful and self-compassionate and (2) experience less burnout and more flourishing. DESIGN An optional one-hour weekly breakfast conference was facilitated by a senior surgical faculty member with the time protected from all clinical duties. Following a guided meditation, participants were given time for reflection and dialogue about their training experiences or led in a wellness exercise. TRANCE (tolerance, respect, anonymity, nonretaliation, compassion, egalitarianism) principles were utilized to create a safe and open environment. Residents were surveyed at the end of the study period, which was from March 2017 through June 2018. SETTING The conference and data analysis was conducted at Denver Health Medical Center, affiliated with the University of Colorado School of Medicine. PARTICIPANTS This study analyzed survey responses from 85 surgical residents. RESULTS Following the wellness program, when answering the 2-question Maslach Burnout Inventory, 35.7% of residents reported feeling burned out by their work once a week or more, and 29.7% reported feeling more callous toward people once a week or more. After multivariate analysis, the only independent predictors of increased burnout were "not being married or in a committed relationship," lower positive affect, and higher negative affect. Written feedback was overwhelmingly positive, and residents expressed gratitude for the conference, the opportunity for self-reflection, and open dialogue with attendings and colleagues. CONCLUSIONS The prevalence of burnout is high among surgical residents. Allowing time to practice a mindfulness meditation while providing space for residents to share their experiences may be protective, and efforts should be made to reduce barriers to participation.
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Affiliation(s)
- George Burnet
- University of Colorado, School of Medicine, Aurora, Colorado.
| | - Carson Platnick
- University of Colorado, School of Medicine, Aurora, Colorado; Denver Health and Hospital Authority, Denver, Colorado
| | - Priya Krishnan
- University of Colorado, School of Medicine, Aurora, Colorado
| | - Caitlin K Robinson
- University of Colorado, School of Medicine, Aurora, Colorado; Denver Health and Hospital Authority, Denver, Colorado
| | - Angela Sauaia
- University of Colorado, School of Medicine, Aurora, Colorado; Denver Health and Hospital Authority, Denver, Colorado
| | | | - Mark R Nehler
- University of Colorado, School of Medicine, Aurora, Colorado
| | - Kshama Jaiswal
- University of Colorado, School of Medicine, Aurora, Colorado
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Pahwa B, Kalyani M, Jain I, Bhattacharjee S. Will you choose neurosurgery as your career? An Indian female medical student perspective. J Clin Neurosci 2022; 105:1-8. [PMID: 36049362 DOI: 10.1016/j.jocn.2022.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/11/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aim at recognising the reasons that discourage female medical students to consider neurosurgery as a career, from an Indian perspective. METHODOLOGY An online survey was disseminated in various medical colleges of India. The study included female medical students (both cis and trans). The questionnaire consisted of objective questions on mentorship, opportunities and exposure. Their concerns on long working hours and the reasons for the same were recorded. RESULTS 348 responses were included of which 79.9 % of students felt they didn't receive proper exposure to neurosurgery in their medical school. 87.4 % of the respondents faced a lack of opportunity and mentorship for research. 65.2 % of students felt that they would be more interested in neurosurgery if a female professor were to mentor them. Long working hours and Reduced Family and Personal time were identified as statistically significant factors (p < 0.001) that play a role in demotivating female medical students towards neurosurgery. Altered quality of life was the most frequent (79.49 %) and significant reason (p = 0.004) as to why long working hours were a concern for them. 65.07 % of participants did not consider physical strength to be a hurdle (p = 0.008). Approximately 37.6 % participants felt that maternity and neurosurgery could be incompatible (p = 0.005). CONCLUSIONS The study brings out the notions that female medical students have regarding the long working hours and decreased family and personal time, complicated by pregnancy and maternal leave in the life of female neurosurgeon.
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Affiliation(s)
- Bhavya Pahwa
- University College of Medical Sciences and GTB Hospital, New Delhi, India.
| | | | - Ishika Jain
- North DMC Medical College & Hindu Rao Hospital, New Delhi, India
| | - Suchanda Bhattacharjee
- Additional. Professor Department of Neurosurgery, Nizam's Institute Of Medical Sciences, Hyderabad, India
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Shahi S, Paudel DR, Bhandari TR. Burnout among resident doctors: An observational study. Ann Med Surg (Lond) 2022; 76:103437. [PMID: 35308433 PMCID: PMC8927790 DOI: 10.1016/j.amsu.2022.103437] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Burnout is a syndrome of emotional exhaustion and depersonalization that reduces efficiency at work. No studies have been reported focusing only on residency burnout and risk factors from our country until now. This study aimed to find out the impact and the association of specific demographic and practice characteristics with burnout among resident doctors. Methods A prospective cross-sectional survey of all resident doctors under training at that point of time in 2019 in the National Academy of Medical Sciences, Nepal in different specialties was done. We evaluated demographic variables, practice characteristics, and assessed burnout through validated Maslach burnout inventory (MBI) tools, and data were analyzed. Results A total 347 among 410 resident doctors (227 male) responded to the survey. Median age was 30 years (range 25–44). Overall, 147 (42.4%) of responding residents were burned out with high emotional exhaustion in 58 (16.6%), high depersonalization in 55 (15.9%), and low personal achievement in 34 (9.8). In regression analysis, out of independent variables gender, marital status, having children, specialty, hours of work per week and year of residency, specialties (general surgery odds ratio [OR]; 12.595, confidence interval [CI],[ 1.037–152.9], P; 0.047), obstetrics, and gynecology (odds ratio [OR]; 13.977, confidence interval [CI]; [1.324–147.5], P; 0.028), and anesthesiology (odds ratio [OR]; 11.54, confidence interval [CI]; [1.014–131.4], P; 0.049)) and hours of work per week (≥80 h) (odds ratio [OR]; 2.511, confidence interval [CI]; [1.128–5.589], P; 0.024), were significantly associated with high burnout. Conclusions Burnout is common among trainee resident doctors which is possibly preventable. Thus, the concern should be to prepare strategies to identify and minimize burnout from the individual, institutional, and societal sides. It is essential to preserve and promote the mental health of trainee residents to prevent serious consequences in the personal lives of resident doctors and as well as on patient outcomes. Burnout amongst resident doctors is extremely predominant which may be caused due to various reasons. We describe the impact of burnout among resident doctors and focus on identifying different risk factors for burnout. Preservation of mental health of resident doctors is essential to prevent serious consequences in their lives as well as on patient care.
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Affiliation(s)
- Sudha Shahi
- Otorhinolaryngology Head and Neck Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
- Corresponding author.
| | - Dhundi Raj Paudel
- Otorhinolaryngology Head and Neck Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Tika Ram Bhandari
- General Surgery, People's Dental College and Hospital, Kathmandu, Nepal
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Morello SL, Shiu KB, Thurston J. Comparison of resident and intern salaries with the current living wage as a quantitative estimate of financial strain among postgraduate veterinary trainees. J Am Vet Med Assoc 2022; 260:124-132. [PMID: 34780353 DOI: 10.2460/javma.21-07-0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare resident and intern salaries with current regional living wages as a quantitative estimate of financial strain. SAMPLE 152 residency programs and 141 internship programs listed with the Veterinary Internship and Residency Matching Program for the 2021-2022 training year. PROCEDURES Data were collected for program annual salary and location. Regional living wage for each location was determined with the Massachusetts Institute of Technology Living Wage Calculator, and annual salary was compared with living wage to estimate income surplus before and after taxes. Results for programs in academia and private practice were compared. Spearman correlation was used to determine whether program annual salary was significantly associated with regional living wage. RESULTS Mean ± SD income surplus before taxes was $7,786 ± 9,426 for clinical residency programs, $16,672 ± 5,105 for laboratory animal programs, and $5,829 ± 8,119 for internships. Academic residencies and internships offered salaries significantly lower than those offered in private practice, and income surpluses before and after taxes were significantly lower for academic programs than for private practice programs. There were weak and moderate, respectively, correlations between program annual salary and regional living wage for residency (r = 0.369) and internship (r = 0.570) programs. CLINICAL RELEVANCE Postgraduate training prolongs financial instability, and annual salaries generally do not meet the minimum income standard of a living wage. Financial stress has implications for mental health and diversity, and these findings invite deeper consideration of current remuneration practices for veterinary residents and interns.
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Affiliation(s)
- Samantha L Morello
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - Kai-Biu Shiu
- VCA Veterinary Emergency Service and Veterinary Specialty Center, Middleton, WI
| | - Joseph Thurston
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
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Zaman S, Ansari AH, Chaturvedi S. Work-life enablers for job satisfaction in healthcare: moderating role of organization type. INDUSTRIAL AND COMMERCIAL TRAINING 2021. [DOI: 10.1108/ict-05-2020-0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to examine how the quality of work-life (QWL) factors influence job satisfaction and tests if organization type moderates this relationship.
Design/methodology/approach
The study adopts a quantitative cross-sectional research design using survey administration among resident doctors used in the Indian health-care sector. Drawing on the person-environment fit theory, leader-member exchange theory and action learning theory, the authors discuss the results.
Findings
Results depicted that in addition to the direct relationship between QWL and job satisfaction, this association is moderated by organization type.
Practical implications
The study provides critical information for health-care managers to prioritize three QWL attributes, namely, meaningful development, supervision, working conditions to enhance job satisfaction among resident doctors.
Originality/value
The study contributes to the limited empirical scholarly research adding a deeper understanding of pertinent factors influencing resident doctor’s QWL-job satisfaction relationship.
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Storman M, Storman D, Maciąg J. Quality of work-life among young medical doctors in Poland. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1611-1617. [PMID: 33944696 DOI: 10.1080/10803548.2021.1917201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives. Human resource management is the most important function in the management of organizations and significantly affects the quality of work-life (QWL). Recently, the health sector started to be interested in the QWL among doctors. The study aim was to assess the QWL among Polish medical residents. Methods. The questionnaire for the medical residents was prepared using data acquired from a review of the international literature. In October 2017, the questionnaires were completed twice by 10 residents with a 2-week interval to assess the inter-rater reliability. The online questionnaire was distributed between April and May 2018. Results. A total of 243 doctors responded, over one-third of whom were men. The QWL was very high for 2.06% of the participants, high for 23.87%, moderate for 27.16%, low for 38.27% and very low for 8.64%. Among the factors that significantly relate to the QWL are the number of working hours per week (p = 0.007) and the general quality of life (p = 0.000). Conclusion. Low QWL is the result of inadequate management in Polish hospitals and residents' QWL still needs to be improved. We propose to conduct such a survey periodically among all young medical doctors to systematically improve their QWL.
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Affiliation(s)
- Monika Storman
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Poland.,Institute of Public Affairs, Jagiellonian University, Poland
| | - Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Justyna Maciąg
- Institute of Public Affairs, Jagiellonian University, Poland
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6th year medical students' future specialty preferences: A cross-sectional study. Ann Med Surg (Lond) 2021; 66:102373. [PMID: 34040768 PMCID: PMC8141496 DOI: 10.1016/j.amsu.2021.102373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studying career preferences can help in designing and improving health service systems. Determining the preferred specialty and understanding the compulsion affecting specialty choice will provide clues to influence such choice in the future to shift the balance of specialties among practitioners. The current study aimed to determine medical students' preferable specialty choices and the factors influencing their choices and their attitude towards postgraduate medical education in Jordan and abroad. MATERIALS AND METHODS The descriptive cross-sectional study design included 6th-year medical students in medical faculties in Jordan. An online questionnaire was created on Google Forms and posted on platforms accessible by medical students at level six. Numbers and percentages were presented for all variables. Frequency distributions were also presented. Chi-square distribution was used to measure the association between categorical data. Alpha level of 0.05 was used. RESULTS Most students 188 (74.3%) preferred to continue their post-graduate training abroad, while only 65 (25.7%) favored Jordan. 150 (59.3%) of the respondents are interested in the medical - non-surgical - specialties. The most important factor that encouraged the students to choose a specialty was Job opportunity (32.5%) followed by the number of years required to complete the training and the expected income (27.7%) each. CONCLUSION Supportive steps should be undertaken to motivate medical graduates toward the needed specialties. Moreover, local Specialty training programs need to be -reevaluated to ensure proper post graduate medical learning.
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Copeland AE, Mackinnon V, Axelrod DE, Farrokhyar F, Avram R, Coroneos CJ. Job Satisfaction Among Plastic Surgery Residents in Canada. Plast Surg (Oakv) 2021; 30:151-158. [PMID: 35572079 PMCID: PMC9096853 DOI: 10.1177/22925503211007237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Resident wellness is a focus of medical training and is prioritized in both
Canadian and American accreditation processes. Job satisfaction is an
important component of wellness that is not examined in the literature. The
purpose of this study was to analyze job satisfaction in a national sample
of plastic surgery residents, and identify factors that influence
satisfaction. Methods: We designed a cross-sectional survey adapted from existing instruments, with
attention to thorough item generation and reduction as well as pilot and
clinical sensibility testing. All plastic surgery residents at Canadian
institutions were surveyed regarding overall job satisfaction as well as
personal- and program-specific factors that may affect satisfaction.
Predictors of satisfaction were identified using multivariable regression
models. Results: The response rate was 40%. Median overall job satisfaction was 4.0 on a
5-point Likert scale. Operative experience was considered both the most
important element of a training program, and the area in most need of
improvement. Senior training year (P < .01), shorter
commute time (P = .04), fewer duty hours
(P = .02), fewer residents (P <
.01), and more fellows (P < .01) were associated with
significantly greater job satisfaction. Conclusions: This is the first study to gather cross-sectional data on job satisfaction
from a national sample of plastic surgery residents. The results from this
study can inform programs in making tangible changes tailored to their
trainees’ needs. Moreover, our findings may be used to inform a
prospectively studied targeted intervention to increase job satisfaction and
resident wellness to address North American accreditation standards.
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Affiliation(s)
- Andrea E. Copeland
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Mackinnon
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel E. Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Forough Farrokhyar
- Department of Health, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ronen Avram
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Christopher J. Coroneos
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Sousa JOD, Dantas RA, Alencar BMAD, Cavalcanti JRLDP, Oliveira LCD, Freire MADM. Análise da qualidade de vida em médicos que trabalham em centro cirúrgico na cidade de Mossoró, Rio Grande do Norte, Brasil. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i3.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objetivo: avaliar a qualidade de vida (QV) em médicos que atuam em centro cirúrgico da cidade brasileira de Mossoró, RN. Métodos: foi realizado um estudo epidemiológico de corte transversal com aplicação de questionários nos profissionais, no período de novembro de 2018 a junho de 2019 em quatro hospitais. Para a caracterização da população estudada, o questionário foi constituído de dados biodemográficos com informações sobre o participante, o modo de trabalho e o questionário World Health Organization Quality of Life abreviado (escore de 0 a 100). Resultados: participaram do estudo 100 médicos de diversas especialidades. A média de idade foi de 39,6 ± 10,7 anos. Os médicos participantes da pesquisa possuíram uma boa QV para todos os todos domínios (escore geral = 75 ± 14,7). Maior idade, mais tempo de formado e maior número de filhos para os domínios físico, psicológico e meio ambiente estiveram relacionados a maior QV. Melhores condições de trabalho estiveram associadas a maiores escores dos domínios social e meio ambiente. Maiores quantidade de horas semanais em plantões se correlacionaram a piores índices de QV para os domínios geral, psicológico, social e meio ambiente. A realização de prática de atividade física foi associada a melhores escores dos domínios geral, físico, social e meio ambiente. Conclusão: Apesar de a maioria dos profissionais apresentarem boa QV, algumas condições estiveram associadas à sua diminuição, como idade mais jovem, elevada carga horária de trabalho, piores condições de trabalho e a não realização de atividades físicas.
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Pitcher GS, Minami HR, Smeds MR. Are Vascular Surgery Trainees Satisfied and are They Using the Right Factors to Choose a Training Program? Ann Vasc Surg 2020; 67:123-133. [PMID: 32272145 DOI: 10.1016/j.avsg.2020.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Medical students and residents often evaluate training sites in vascular surgery with minimal exposure to those programs. We sought to identify factors associated with vascular surgery trainee satisfaction in relation to their current work environment and how they made their rank list. METHODS All integrated residents and fellows currently in United States vascular training programs were queried using an anonymous electronic survey for variables of their current training environment, factors that influenced their rank order list, and satisfaction. Questions were graded on a Likert scale. Continuous, ordinal, and categorical variables were respectively analyzed using the two-sample t-test, Mann-Whitney U-test/Wilcoxon rank sum test, and Fisher's exact test. RESULTS A total of 166 of 517 (32%) trainees completed the survey with equal distribution across postgraduate years. Respondents reported high rates of satisfaction with their training program overall (84%), including 88% (n = 83) of residents and 78% (n = 56) of fellows. Several work environment variables were associated with both resident and fellow satisfaction including program-funded trips for conferences and presentations (P = 0.027 for residents; P = 0.001 for fellows), diversity of operative cases (P = 0.024; P < 0.001), perception of a strong supportive social network at the hospital (P = 0.006; P = 0.001), and perception of appreciation by attending surgeons (P < 0.001; P < 0.001). Fellows who felt appreciated by nursing staff (P = 0.047), ancillary staff (P = 0.013), and patients were more likely to be satisfied (P = 0.011); however, this was not true for integrated residents. Social outings with nontrainee family and friends were associated with satisfaction for fellows (P = 0.002) but not integrated residents (P = 0.138), whereas social outings with vascular trainees were associated with satisfaction for integrated residents (P = 0.047) but not fellows (P = 0.375). Similarly, satisfied integrated residents were more likely to have close relationships with their vascular cotrainees (P = 0.035) than fellows (P = 0.349). No rank list factors were found to be predictive of current trainee satisfaction for integrated residents. Rank list factors associated with fellow satisfaction included recommendation of the institution from a mentor (P < 0.001), success of program graduates (P = 0.002), faculty (P = 0.014), perceived program prestige (P = 0.040), and amount of early operative exposure (P = 0.042). CONCLUSIONS Vascular surgery trainees report a high level of satisfaction with their training program. Fellow satisfaction was more dependent on the perception of their workplace peers than integrated residents. Satisfied integrated residents were more likely to have close relationships with their vascular cotrainees than fellows.
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Affiliation(s)
- Grayson S Pitcher
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.
| | - Hataka R Minami
- Division of Vascular and Endovascular Surgery, SSM Health St. Louis University Hospital, St. Louis University School of Medicine, St. Louis, MO
| | - Matthew R Smeds
- Division of Vascular and Endovascular Surgery, SSM Health St. Louis University Hospital, St. Louis University School of Medicine, St. Louis, MO
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Debono D, Robertson H, Travaglia J. Organisational communication as trespass: a patient safety perspective. J Health Organ Manag 2019. [DOI: 10.1108/jhom-10-2018-0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Significant, sustained improvement in patient safety has proved an intractable goal. Attempts to address persistent problems have largely focused on technical solutions to issues conceptualised as clinical, cultural or system based. While communication is at the core of many remediation strategies, the focus has remained largely on communication between clinicians or between clinicians and patients, and on creating centralised guidelines as communicative mechanisms to transmit approved practice. Yet, current attempts at improvement have had limited impact. The purpose of this paper is to highlight vital new ways of conceptualising and exploring the relations and actions that are meant to constitute safety within organisations.
Design/methodology/approach
Utilising theory from social sciences, the authors reconceptualise trespass and transgression, traditionally positioned as infringements, as acts of resistance: mechanisms for intrusion which intentionally or unintentionally disrupt the territorial claims of professions and organisations to enhance patient safety.
Findings
Drawing on the literature, research and professional experience, two forms of trespass are discussed: the intrusion of largely invisible and understudied ancillary staff into the world of clinicians; and the use of workarounds by clinicians themselves. In both cases, transgressors intend to increase rather than decrease patient safety and may, upon further examination, prove to do so.
Originality/value
Trespasses and transgressions considered in this light offer the opportunity to make visible people, relationships and actions which have previously remained hidden in our understanding of, and therefore proposed solutions to, patient safety.
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Smith C, Rao A, Tompach PC, Petersen A, Lyu D, Nadeau RA. Factors Associated With the Mental Health and Satisfaction of Oral and Maxillofacial Surgery Residents in the United States: A Cross-Sectional Study and Analysis. J Oral Maxillofac Surg 2019; 77:2196-2204. [PMID: 31422015 DOI: 10.1016/j.joms.2019.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Residents in training have reported high levels of stress and anxiety and have a greater risk of mental health problems compared with the general population. Mental health problems among residents have been correlated with decreased professional effectiveness, increased medical errors, emotional exhaustion, and depersonalization and could have significant negative effects on future practitioners. The purpose of the present study was to identify the factors that might be associated with the mental health and satisfaction of oral and maxillofacial surgery (OMS) residents and to determine the associations between these factors and OMS resident satisfaction as a surrogate of resident well-being. MATERIALS AND METHODS We designed and implemented an online survey, which was e-mailed to all OMS residents in the 101 accredited training programs in the United States. The survey was designed to determine and assess the factors associated with OMS resident satisfaction. Differences between groups were tested using 1-way analysis of variance for continuous variables and χ2 tests for categorical variables. For each factor, we fit a logistic regression model to estimate the odds ratio of resident satisfaction for the factor, adjusting for gender, year in residency, and years of advanced training. RESULTS Of the 1181 resident surveys sent out, 300 were completed (25.4% response rate). The satisfied OMS residents tended to be men, further along in their training program, and to have access to mental health resources. Dissatisfaction was associated with greater self-reported stress levels, working a greater number of hours per week, and believing one would be viewed differently for speaking to faculty about mental health. CONCLUSIONS OMS resident satisfaction was associated with identifiable and potentially modifiable factors. These factors included workload characteristics, stress and coping ability, and mental health impact and resource availability. Evidence-based strategies for OMS resident well-being could lead to the development of best practice guidelines for promoting and optimizing resident mental health.
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Affiliation(s)
- Charlie Smith
- Dental Student, Division of Oral and Maxillofacial Surgery, University of Minnesota School of Dentistry, Saint Paul, MN
| | - Aarathi Rao
- Resident, Division of Oral and Maxillofacial Surgery, University of Minnesota School of Dentistry, Saint Paul, MN
| | - Paul C Tompach
- Assistant Clinical Professor, Division of Oral and Maxillofacial Surgery, University of Minnesota School of Dentistry, Saint Paul, MN.
| | - Ashley Petersen
- Assistant Professor, Division of Biostatistics, University of Minnesota School of Public Health, Saint Paul, MN
| | - Diana Lyu
- Resident, Division of Oral and Maxillofacial Surgery, University of Minnesota School of Dentistry, Saint Paul, MN
| | - Robert A Nadeau
- Clinical Associate Professor and Clinic and Graduate Training Program Director, Division of Oral and Maxillofacial Surgery, University of Minnesota School of Dentistry, Saint Paul, MN
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Li X, Pagani N, Curry EJ, Alolabi B, Dickens JF, Miller AN, Mesfin A. Factors Influencing Resident Satisfaction and Fellowship Selection in Orthopaedic Training Programs: An American Orthopaedic Association North American Traveling Fellowship Project. J Bone Joint Surg Am 2019; 101:e46. [PMID: 31094993 DOI: 10.2106/jbjs.17.00928] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is limited literature available about educational satisfaction and fellowship selection among orthopaedic surgery residents. The purpose of this study was to identify factors that influence resident subspecialty career choice, fellowship selection, and satisfaction with orthopaedic training programs. METHODS A self-report survey was electronically administered to orthopaedic surgery residents at 44 academic centers in the United States and Canada. Basic demographic information and level of satisfaction with a number of factors (surgical independence, mentorship opportunities, etc.) were evaluated using a 5-point Likert scale ranging from "excellent" to "poor." Summary statistics and group differences for discrete variables were compared with use of a chi-square test. RESULTS Of the 283 respondents, 77% rated residency program satisfaction as "very good" or "excellent," and 93% said they would choose the same training program again. Decreased surgical independence (p < 0.01), poor faculty reputation (p < 0.01), reduced volume and variety of cases (p < 0.01), inadequate mentorship (p < 0.01), and reduced educational opportunities (p < 0.01) were associated with low satisfaction. Surgical variety and job opportunities were the top 2 factors contributing to subspecialty choice. Sports medicine and joints were the most popular career choices; case volume, surgical variety, and program reputation were the top factors contributing to fellowship program selection. CONCLUSIONS In order to achieve resident satisfaction, orthopaedic training programs should strive to improve resident surgical independence, surgical case variety, mentorship programs, faculty reputation, and educational opportunities. Important factors for fellowship program selection include case volume, surgical variety, and overall program reputation.
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Affiliation(s)
- Xinning Li
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Emily J Curry
- Boston University School of Public Health, Boston, Massachusetts
| | | | | | - Anna N Miller
- Washington University Orthopedics, St. Louis, Missouri
| | - Addisu Mesfin
- University of Rochester Medical Center, Rochester, New York
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Appelbaum NP, Lee N, Amendola M, Dodson K, Kaplan B. Surgical Resident Burnout and Job Satisfaction: The Role of Workplace Climate and Perceived Support. J Surg Res 2018; 234:20-25. [PMID: 30527474 DOI: 10.1016/j.jss.2018.08.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/30/2018] [Accepted: 08/18/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Surgical residents train under immense stress, often manifesting into poor well-being. While recent research identifies methods of coping with stress, few studies empirically investigate the role of the environment on surgical resident well-being. We aimed to assess surgical resident perceptions of workplace climate, organizational support, burnout, and job satisfaction to test a mediation model identifying antecedents to well-being. MATERIALS AND METHODS A convenience sampling of program directors from general surgery within the Eastern region of the United States were emailed to request either agenda time to collection data via paper survey or to forward an electronic survey link to their residents between March 2016 and June 2016. The survey included scales demonstrating validity evidence on well-being, climate, and perceptions of support. RESULTS Based on 160 general surgery residents (out of 557; 29% response rate) across 19 training programs, our mediation model found that job satisfaction was significantly predicted by workplace climate directly (direct effect = 0.37, 95% CI [0.19, 0.55]) and indirectly (specific indirect effect = 0.07, 95% CI [0.01, 0.13]) through perceived organizational support and burnout, while controlling for training year and gender, F(5,147) = 53.76, P < 0.001, Rsq. = 0.65. CONCLUSIONS Medical education requires an additional focus on how the clinical learning environment affects surgical resident well-being. Health systems and training programs will need to collaborate on workplace innovations to improve workplace climate for trainees to address the concerns of well-being with a modern surgical workforce.
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Affiliation(s)
- Nital P Appelbaum
- Virginia Commonwealth University, School of Medicine Dean's Office, Richmond, Virginia.
| | - Nathaniel Lee
- Virginia Commonwealth University, Department of Surgery, Richmond, Virginia
| | - Michael Amendola
- Virginia Commonwealth University, Department of Surgery, Richmond, Virginia
| | - Kelley Dodson
- Virginia Commonwealth University, Department of Otolaryngology, Richmond, Virginia
| | - Brian Kaplan
- Virginia Commonwealth University, Department of Surgery, Richmond, Virginia
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Mohr DC, Eaton JL, Meterko M, Stolzmann KL, Restuccia JD. Factors associated with internal medicine physician job attitudes in the Veterans Health Administration. BMC Health Serv Res 2018; 18:244. [PMID: 29622008 PMCID: PMC5885351 DOI: 10.1186/s12913-018-3015-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 03/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background US healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator. Further, many health care organizations also have an academically oriented mission. Physician involvement in research and teaching may lead to more positive workplace attitudes, with subsequent decreases in turnover and beneficial impact on patient care. This article aimed to understand the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among internal medicine physicians in the Veterans Health Administration (VHA). Methods A cross-sectional survey was conducted with inpatient attending physicians from 36 Veterans Affairs Medical Centers. Participants were surveyed regarding demographics, practice settings, workplace staffing, perceived quality of care, and job attitudes. Job attitudes consisted of three measures: overall job satisfaction, intent to leave the organization, and burnout. Analysis used a two-level hierarchical model to account for the nesting of physicians within medical centers. The regression models included organizational-level characteristics: inpatient bed size, urban or rural location, hospital teaching affiliation, and performance-based compensation. Results A total of 373 physicians provided useable survey responses. The majority (72%) of respondents reported some level of teaching involvement. Almost half (46%) of the sample reported some level of research involvement. Degree of research involvement was a significant predictor of favorable ratings on physician job satisfaction and intent to leave. Teaching involvement did not have a significant impact on outcomes. Perceived quality of care was the strongest predictor of physician job satisfaction and intent to leave. Perceived levels of adequate physician staffing was a significant contributor to all three job attitude measures. Conclusions Expanding opportunities for physician involvement with research may lead to more positive work experiences, which could potentially reduce turnover and improve system performance. Electronic supplementary material The online version of this article (10.1186/s12913-018-3015-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David C Mohr
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA. .,Boston University School of Public Health, Boston, MA, USA.
| | - Jennifer L Eaton
- Department of Veterans Affairs, Office of Patient Care Services, Occupational Health Services, Washington, DC, USA
| | - Mark Meterko
- VA Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID -10EA), Field-based at the Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA.,Boston University School of Public Health, Boston, MA, USA
| | - Kelly L Stolzmann
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA
| | - Joseph D Restuccia
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston VA Healthcare System, 150 South Huntington Ave, 152M, Boston, MA, 02130, USA.,Boston University Questrom School of Business, Boston, MA, USA
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Cleland J, Roberts R, Kitto S, Strand P, Johnston P. Using paradox theory to understand responses to tensions between service and training in general surgery. MEDICAL EDUCATION 2018; 52:288-301. [PMID: 29105861 DOI: 10.1111/medu.13475] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/26/2017] [Accepted: 09/06/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT The tension between service and training in pressured health care environments can have a detrimental impact on training quality and job satisfaction. Yet the management literature proposes that competing demands are inherent in organisational settings: it is not the demands as such that lead to negative outcomes but how people and organisations react to opposing tensions. We explored how key stakeholders responded to competing service-training demands in a surgical setting that had recently gone through a highly-publicised organisational crisis. METHODS This was an explanatory case study of a general surgery unit. Public documents informed the research questions and the data were triangulated with semi-structured interviews (n = 14) with key stakeholders. Data coding and analysis were initially inductive but, after the themes emerged, we used a paradox lens to group themes into four contextual dimensions: performing, organising, belonging and learning. RESULTS Tensions were apparent in the data, with managers, surgeons and trainees or residents in conflict with each other because of different goals or priorities and divergent perspectives on the same issue of balancing service and training (performing). This adversely impacted on relationships across and within groups (belonging, learning) and led to individuals prioritising their own goals rather than working for the 'greater good' (performing, belonging). Yet although relationships and communication improved, the approach to getting a better balance maintained the 'compartmentalisation' of training (organising) rather than acknowledging that training and service cannot be separated. DISCUSSION Stakeholder responses to the tensions provided temporary relief but were unlikely to lead to real change if the tension between service and training was considered to be an interdependent and persistent paradox. Reframing the service-training paradox in this way may encourage adjusting responses to create effective working partnerships. Our findings add to the body of knowledge on this topic, and will resonate with all those engaged in surgical and other postgraduate training.
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Affiliation(s)
- Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Ruby Roberts
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Simon Kitto
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
| | - Pia Strand
- The Faculty of Medicine Centre for Teaching and Learning, Lund University, Lund, Sweden
| | - Peter Johnston
- NHS Education for Scotland, Northern Deanery, Aberdeen, UK
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Demographics, Interests, and Quality of Life of Canadian Neurosurgery Residents. Can J Neurol Sci 2017; 45:214-220. [DOI: 10.1017/cjn.2017.263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents.Methods:A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016.Results:We analyzed 76 completed surveys of 146 eligible residents (52% response rate). The median age was 29 years, with 76% of respondents being males. The most popular subspecialties of interest for fellowship were spine, oncology, and open vascular neurosurgery. The most frequent self-reported number of worked hours per week was the 80- to 89-hour range. The majority of respondents reported a high level of happiness as well as stress. Sense of accomplishment and fatigue were reported as average to high and overall quality of life was low for 19%, average for 49%, and high for 32%. Satisfaction with work-life balance was average for 44% of respondents and was the only tested domain in which significant dissatisfaction was identified (18%). Overall, respondents were highly satisfied with their choice of specialty, choice of program, surgical exposure, and work environment; however, intimidation was reported in 36% of respondents and depression by 17%.Conclusions:Despite a challenging residency and high workload, the majority of Canadian neurosurgery residents are happy and satisfied with their choice of specialty and program. However, work-life balance, employability, resident intimidation, and depression were identified as areas of active concern.
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Luiz RB, Simões ALDA, Barichello E, Barbosa MH. Factors associated with the patient safety climate at a teaching hospital. Rev Lat Am Enfermagem 2017; 23:880-7. [PMID: 26487138 PMCID: PMC4660410 DOI: 10.1590/0104-1169.0059.2627] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 02/21/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives: to investigate the association between the scores of the patient safety climate
and socio-demographic and professional variables. Methods: an observational, sectional and quantitative study, conducted at a large public
teaching hospital. The Safety Attitudes Questionnaire was used, translated and
validated for Brazil. Data analysis used the software Statistical Package for
Social Sciences. In the bivariate analysis, we used Student's t-test, analysis of
variance and Spearman's correlation of (α=0.05). To identify predictors for the
safety climate scores, multiple linear regression was used, having the safety
climate domain as the main outcome (α=0.01). Results: most participants were women, nursing staff, who worked in direct care to adult
patients in critical areas, without a graduate degree and without any other
employment. The average and median total score of the instrument corresponded to
61.8 (SD=13.7) and 63.3, respectively. The variable professional performance was
found as a factor associated with the safety environment for the domain perception
of service management and hospital management (p=0.01). Conclusion: the identification of factors associated with the safety environment permits the
construction of strategies for safe practices in the hospitals.
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Real K, Fields-Elswick K, Bernard AC. Understanding Resident Performance, Mindfulness, and Communication in Critical Care Rotations. JOURNAL OF SURGICAL EDUCATION 2017; 74:503-512. [PMID: 28025061 DOI: 10.1016/j.jsurg.2016.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/24/2016] [Accepted: 11/26/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team. DESIGN This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance. SETTING Academic, tertiary medical center. PARTICIPANTS Residents (N = 51) working in an intensive care unit. In phase I, medical residents completed a self-report survey of mindfulness, communication, emotional affect, and clinical decision-making. In phase II, resident performance was assessed using independent ratings of mindfulness and clinical decision-making by attending physicians and registered nurses. RESULTS In phase 1, a significant positive relationship was found between resident performance and mindfulness, positive affect (PA), and communication. In phase 2, attending physicians/registered nurses' perceptions of residents' mindfulness were positively correlated with communication and inversely related to negative affect (NA). The top quartile of residents for performance and mindfulness had the lowest NA. Higher-rated residents underestimated their performance/mindfulness, whereas those in the lowest quartile overestimated these factors. CONCLUSIONS This study offers a number of implications for medical resident education. First, mindfulness was perceived to be a significant contributor to self-assessments of competency and performance. Second, both PA and NA were important to mindfulness and performance. Third, communication was associated with resident performance, mindfulness, and PA. These implications suggest that individual characteristics of mindfulness, communication, and affect, all potentially modifiable, influence care quality and safety. To improve low performers, surgical educators could screen and identify residents with inaccurate self-assessments. Residents open to feedback will improve faster and develop awareness toward situations and interactions with patients, colleagues, attending physicians, and staff.
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Affiliation(s)
- Kevin Real
- Department of Communication, University of Kentucky, Lexington, Kentucky
| | | | - Andrew C Bernard
- Department of Surgery, UK Healthcare, University of Kentucky, Lexington, Kentucky.
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Pedrazza M, Berlanda S, Trifiletti E, Bressan F. Exploring Physicians' Dissatisfaction and Work-Related Stress: Development of the PhyDis Scale. Front Psychol 2016; 7:1238. [PMID: 27588013 PMCID: PMC4988987 DOI: 10.3389/fpsyg.2016.01238] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/03/2016] [Indexed: 11/13/2022] Open
Abstract
Research, all over the world, is starting to recognize the potential impact of physicians' dissatisfaction and burnout on their productivity, that is, on their intent to leave the job, on their work ability, on the amount of sick leave days, on their intent to continue practicing, and last but not least, on the quality of the services provided, which is an essential part of the general medical care system. It was interest of the provincial medical board's ethical committee to acquire information about physician's work-related stress and dissatisfaction. The research group was committed to define the indicators of dissatisfaction and work-related stressors. Focus groups were carried out, 21 stressful experience's indicators were identified; we developed an online questionnaire to assess the amount of perceived stress relating to each indicator at work (3070 physicians were contacted by e-mail); quantitative and qualitative data analysis were carried out. The grounded theory perspective was applied in order to assure the most reliable procedure to investigate the concepts' structure of "work-related stress." We tested the five dimensions' model of the stressful experience with a confirmatory factor analysis: Personal Costs; Decline in Public Image and Role Uncertainty; Physician's Responsibility toward hopelessly ill Patients; Relationship with Staff and Colleagues; Bureaucracy. We split the sample according to attachment style (secure and insecure -anxious and avoidant-). Results show the complex representation of physicians' dissatisfaction at work also with references to the variable of individual difference of attachment security/insecurity. The discriminant validity of the scale was tested. The original contribution of this paper lies on the one hand in the qualitative in depth inductive analysis of physicians' dissatisfaction starting from physicians' perception, on the other hand, it represents the first attempt to analyze the physicians' dissatisfaction with reference to attachment styles, which is recognized as being a central variable of individual difference supporting caregiving practices. This study represents an original and innovative attempt to address physicians' dissatisfaction and job satisfaction. The PhyDis scale has been developed and, in line with international findings, our results indicate that role uncertainty and loss of social esteem are the most dissatisfying factors.
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Affiliation(s)
- Monica Pedrazza
- Department of Human Sciences, University of VeronaVerona, Italy
| | | | | | - Franco Bressan
- Department of Economics, University of VeronaVerona, Italy
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Lussiez A, Bevins J, Plaska A, Rosin V, Reddy RM. General Surgery Resident Satisfaction on Cardiothoracic Rotations. JOURNAL OF SURGICAL EDUCATION 2016; 73:95-100. [PMID: 26531743 DOI: 10.1016/j.jsurg.2015.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/21/2015] [Accepted: 09/07/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE General surgery residents' exposure to cardiothoracic (CT) surgery rotations has decreased, which may affect resident satisfaction. We surveyed general surgery graduates to assess the relationships among rotation satisfaction, CT disease exposure, rotation length, mentorship, and mistreatment. DESIGN A survey assessing CT curriculum, exposure, mentorship, and satisfaction was forwarded to general surgery graduates from 17 residency programs. A Wilcoxon rank-sum test was used to assess statistical significance of ordinal level data. Statistical significance was defined as p < 0.05. SETTING This study was conducted at the University of Michigan Health System in Ann Arbor, MI, a tertiary care center. PARTICIPANTS The survey was sent to approximately 1300 graduates of general surgery residency programs who graduated between the years of 1999 to 2014. A total of 94 responses were completed and received. RESULTS Receiving adequate exposure to CT procedures and disease management was significantly associated with higher satisfaction ratings for all procedures, particularly thoracotomy incisions (p < 0.001), empyemas and pleural effusions (p < 0.001), and lung cancer care (p < 0.001). The absence of mistreatment and good/very good mentorship were both positively associated with higher reported satisfaction (p = 0.018 and p < 0.001, respectively). Increased length of time on CT rotation was neither associated with improved levels of satisfaction nor with an improvement in the quality of mentorship. CONCLUSION Rotation satisfaction is positively associated with procedure exposure, better mentorship, and the absence of mistreatment. Longer rotation length was not associated with satisfaction. Shorter rotations are not detrimental to training if they have focused clinical exposure and invested mentors to maximize resident satisfaction. These specific markers of rotation quality are useful in curricular design.
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Affiliation(s)
- Alisha Lussiez
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Jack Bevins
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Andrew Plaska
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Vadim Rosin
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Rishindra M Reddy
- University of Michigan Medical School, Ann Arbor, Michigan; Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan.
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Mataya AA, Macuvele ME, Gwitima T, Muula AS. Factors affecting job satisfaction and commitment among medical interns in Malawi: a cross-sectional study. Pan Afr Med J 2015; 21:174. [PMID: 34405035 PMCID: PMC8352791 DOI: 10.11604/pamj.2015.21.174.6511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/19/2015] [Indexed: 11/13/2022] Open
Abstract
Introduction the University of Malawi's College of Medicine produces almost all of the medical interns working at Malawi's two largest public hospitals: Queen Elizabeth Central Hospital in Blantyre, and Kamuzu Central Hospital in Lilongwe. To earn full medical council registration, new graduates must complete an 18-month internship at either site. This study attempted to determine general levels of job satisfaction and commitment among Malawian medical interns, and to rank categorical factors according to impact on intern job satisfaction and commitment. These factors were also examined in terms of influence on bringing about an intern strike in late 2010, early 2011. Methods sixty-one of 70 interns working during the study period completed a job satisfaction survey. Questionnaire items addressed ten “factors”: (1) hours and pay, (2) work content, (3) working conditions, (4) relationships with senior staff, (5) workplace relationships with peers, (6) educational environment, (7) internal factors, (8) quality of life, (9) autonomy and self-worth, and (10) future career prospects. Analysis for this cross-sectional study included quantification and comparisons of overall and category-specific satisfaction levels, using ANOVA and Student's t-test. Results sixty-nine percent then 57% of interns identified themselves as satisfied at the beginning and end of the questionnaire, respectively; 97% of the interns indicated job commitment at both instances of asking. Factors influencing job satisfaction most strongly were those that participants were least satisfied with. Conclusion future research and interventions aimed at improving intern job satisfaction in Malawi should focus on assessing and improving remuneration, working hours, and physical working conditions.
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Affiliation(s)
- Andrew Alinafe Mataya
- Department of Community Health, College of Medicine, University of Malawi, P/B 360 Chichiri, Blantyre 3, Malawi
| | - Marcia Eugenia Macuvele
- Department of Community Health, College of Medicine, University of Malawi, P/B 360 Chichiri, Blantyre 3, Malawi
| | - Takudzwanashe Gwitima
- Department of Community Health, College of Medicine, University of Malawi, P/B 360 Chichiri, Blantyre 3, Malawi
| | - Adamson Sinjani Muula
- Department of Community Health, College of Medicine, University of Malawi, P/B 360 Chichiri, Blantyre 3, Malawi
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Oristrell J, Oliva J, Casanovas A, Comet R, Jordana R, Navarro M. The Computer Book of The Internal Medicine Resident: Competence acquisition and achievement of learning objectives. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2013.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives. Rev Clin Esp 2013; 214:8-16. [PMID: 24035662 DOI: 10.1016/j.rce.2013.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/23/2013] [Accepted: 07/28/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents. OBJECTIVES To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction. METHODS All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis. RESULTS An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction. CONCLUSIONS Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine.
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Enari T, Hashimoto H. Does salary affect the choice of residency in non-university teaching hospitals? A panel analysis of Japan Residency Matching Programme data. HUMAN RESOURCES FOR HEALTH 2013; 11:12. [PMID: 23496935 PMCID: PMC3600031 DOI: 10.1186/1478-4491-11-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 02/18/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Previous studies have investigated factors that are influential on the choice of training hospitals among residency physicians, but the effect of salary was not conclusive. In this study, we aimed to examine whether a higher salary attracted more residents to non-university hospitals participating in the Japanese Residency Matching Programme. METHODS Data on 475 hospitals/programmes between 2006 and 2009 were available for analysis. We first conducted an ordinary least squares regression analysis on the ratio of the number of applicants to the residency programme quota as an index of resident's choice, for comparison with previous studies. We further performed panel data analysis to better control for unobserved heterogeneity across hospitals, which could be confounded by the amount of salary. We also performed stratified analysis by the population size of the hospital location. RESULTS In ordinary least squares regression, salary showed a positive, but not significant association, with the ratio of the number of applicants to the programme quota, while the results of a fixed effect model exhibited a positive and significant effect of salary (ε= 0.4995, P = 0.015) on the ratio. Analysis stratified by city size showed that the elasticity of salary was comparable (ε= 1.9089, P = 0.016 in large cities versus ε= 1.9185, P = 0.008 in small cities), while that of the number of teaching physicians was larger in large cities (ε= 1.9857, P = 0.009) compared with that in small cities (ε= 1.6253, P = 0.033). The number of teaching physicians had a significant and negative effect modification on salary, implying an antagonistic effect between these two attributes (ε= -1.5223, P = 0.038). CONCLUSIONS Our results indicate that the amount of salary influences the choice of training hospitals among medical graduates who choose non-university settings. Use of a monetary reward in a residency programme could be a feasible tactic for hospitals to attract residents.
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Affiliation(s)
- Taiji Enari
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hideki Hashimoto
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Kirton OC, Reilly P, Staff I, Burns K. Development and implementation of an interactive, objective, and simulation-based curriculum for general surgery residents. JOURNAL OF SURGICAL EDUCATION 2012; 69:718-723. [PMID: 23111036 DOI: 10.1016/j.jsurg.2012.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/14/2012] [Accepted: 05/14/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE A Steering Committee of residents and faculty initiated a systematic approach to curriculum development, focusing on competency-based education and emphasizing both resident and faculty engagement in the didactic process. SETTING Integrated General Surgery Residency Program at the University of Connecticut School of Medicine, Farmington, Connecticut. PARTICIPANTS Postgraduate year (PGY) 1 through 5 general surgery categorical and preliminary residents. METHODS A Core Curriculum consisting of 45-minute blocks and 2.5 hours of resident time per week was developed by a steering committee composed of faculty and residents. Each block is assigned a faculty and resident moderator, and has defined competency and knowledge-based objectives. An anonymous online evaluation tool collected residents' perceptions of value and satisfaction with the curriculum utilizing 15 5-point Likert items focusing on conferences, objectives, preparation, and quality of presentations, and materials. Measures were taken at the close of the previous academic year (baseline) and at 6 months and 1 year after implementation. The analysis focused on the percent responding in the 2 highest Likert categories (good/excellent, almost always/always, agree/strongly agree). The resulting dichotomous outcomes were compared with time point using χ(2)-tests of proportion; Kruskal-Wallis statistic was also used to compare the full distribution of responses. All analyses were done using SPSS v. 14 with α = 0.05. RESULTS One hundred two surveys were completed on-line (42 at baseline, 38 at 6 months, and 22 at 1 year). All 15 items showed increases from baseline to 1-year follow-up; 9 of the 15 were statistically significant with conferences and presentation quality and interaction showing the greatest improvement. CONCLUSIONS Resident satisfaction with the core curriculum, and their self-reported clinical and academic abilities showed improvement after a systematic collaborative faculty-resident approach to curriculum development and implementation.
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Affiliation(s)
- Orlando C Kirton
- Department of Surgery, University of Connecticut School of Medicine, Farmington, CT, USA.
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Hills D, Joyce C, Humphreys J. Validation of a Job Satisfaction Scale in the Australian Clinical Medical Workforce. Eval Health Prof 2011; 35:47-76. [DOI: 10.1177/0163278710397339] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Danny Hills
- School of Public Health and Preventive Medicine, Monash University
| | - Catherine Joyce
- School of Public Health and Preventive Medicine, Monash University
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Mazeh H, Mizrahi I, Eid A, Freund HR, Allweis TM. Medical students and general surgery--Israel's National Survey: lifestyle is not the sole issue. JOURNAL OF SURGICAL EDUCATION 2010; 67:303-308. [PMID: 21035770 DOI: 10.1016/j.jsurg.2010.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 07/20/2010] [Accepted: 07/27/2010] [Indexed: 05/30/2023]
Abstract
BACKGROUND In recent years, a significant decline in the number of medical school graduates who choose general surgery as a career has been noted in Israel. The aim of this study is to characterize the factors that deter Israeli medical students from choosing general surgery. Previous studies in the United States identified lifestyle and financial issues as the most important factors. METHODS A web-based survey was distributed to graduating medical students throughout Israel. The survey covered different factors and aspects affecting career choice, requiring participants to rate their choices with a 1-5 score. RESULTS In all, 218 surveys were completed; 72 (33%) students considered general surgery before the surgical clerkship versus only 48 (22%) students after. Professional interest and satisfaction (4.7) were ranked as the most important factors for choosing a residency, followed by an amiable working atmosphere (4.3). The 2 strongest deterrents from general surgery were doctors' inter-relationships (3.5) and compromised lifestyle (3.3). The decision to avoid surgery can be reversed by improving both lifestyle (3.5) and inter-relationships (3.0), but it is less influenced by a substantial increase in residents' salary. CONCLUSIONS More medical graduates would consider general surgery as a career option if the lifestyle and inter-relationships were perceived as better. An increase in monetary reward did not seem to have a paramount impact among Israeli medical graduates. The surgical clerkship is an important turning point in the students' attitude toward surgery as a career and efforts must be made to improve students' experience significantly during this clerkship.
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Affiliation(s)
- Haggi Mazeh
- Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
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Wang XY, Rodríguez AC, Shu MR. Challenges to implementation of medical residency programs in China: a five-year study of attrition from West China hospital. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:1203-1208. [PMID: 20592516 DOI: 10.1097/acm.0b013e3181e1388a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To increase opportunities for advanced clinical training, a few medical schools in China have created U.S.-style, temporary-contract residency programs for medical graduates, but nearly nothing is known about what proportion of residents successfully complete these programs or what factors affect attrition. METHOD By directly surveying and interviewing residents who withdrew voluntarily, the authors examined attrition from 16 medical specialties in the residency program of West China Hospital, Sichuan University, from the start of the program in 2003 through 2008. RESULTS During the study period, 562 trainees matriculated into the program, and 127 (22.6%) withdrew before completing it; 106 (18.9%) withdrew voluntarily. Those who left voluntarily most frequently cited three reasons: (1) permanent employment in other hospitals, (2) pursuit of a higher academic degree, and (3) personal reasons. Nearly 90% (n = 92) of the residents who left voluntarily did so within two years of obtaining their medical license. Women were 1.82-fold more likely than men to leave (95% CI 1.20-2.76, P = .005). Attrition by specialty ranged from 3.7% to 42.9% over the study period. Surgery had one of the lowest attrition rates. CONCLUSIONS Attrition is a challenge for the West China residency program just as it is for U.S. residency programs, but the factors behind attrition in each country differ significantly. To reduce attrition from temporary-contract residency programs in China, the programs themselves and government policies may need to change so that completing such residencies is as competitive an option as taking permanent hospital positions immediately after graduation.
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Affiliation(s)
- Xing Yue Wang
- West China Hospital, Sichuan University, Chengdu, China
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Holt KD, Miller RS, Philibert I, Heard JK, Nasca TJ. Residents' perspectives on the learning environment: data from the Accreditation Council for Graduate Medical Education resident survey. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:512-518. [PMID: 20182130 DOI: 10.1097/acm.0b013e3181ccc1db] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE Residents' assessment of their learning environment is an important element of residency accreditation and a strong predictor of resident satisfaction. The authors examined the reliability and validity of a resident/fellow survey and explored the relationship between reported duty hours noncompliance and residents' perceptions of other aspects of their learning environments. METHOD The Accreditation Council for Graduate Medical Education (ACGME) administered a 29-item Web-based survey in 2007 and 2008 to 91,073 residents in 5,610 programs. Aggregate data from the survey comprised indicators of substantial compliance or noncompliance. The authors examined relationships among duty hours and aspects of the educational environment, as well as the relationship of the survey results to citations from accreditation reviews. RESULTS The survey demonstrated a high degree of internal reliability (Cronbach alpha, 0.84). Common factor analysis revealed two factors, educational environment and resident duty hours (eigenvalues of 5.49 and 2.42, respectively). Programs having resident-identified duty hours issues were more likely than those without such issues to have received duty hours citations from residency review committees (odds ratio: 2.04; 95% CI: 1.03, 3.05). CONCLUSIONS The ACGME Resident/Fellow Survey is a reliable, valid, and useful tool for evaluating residency programs. There are strong relationships between duty hours noncompliance and noncompliance in other aspects of the program environment.
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Affiliation(s)
- Kathleen D Holt
- Accreditation Council for Graduate Medical Education, Chicago, Illinois 60654, USA.
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