Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey

Training in obstetrics and gynecology between reality and vision: results of a JAGO-NOGGO survey in 601 physicians (NOGGO-Monitor-12 trial)

PURPOSE

The primary objective of this study was to establish a benchmark by collecting baseline data on surgical education in obstetrics and gynecology in Germany, including factual number of operations performed.

MATERIALS AND METHODS

A nationwide anonymous survey was conducted in Germany between January 2019 and July 2019 utilizing a specially designed questionnaire which addressed both residents and senior trainers.

RESULTS

A total of 601 participants completed the survey, comprising 305 trainees and 296 trainers. The trainees reported performing a median of 125 non-obstetric surgeries (IQR: 41-332) and 75 obstetric procedures (IQR: 27-168) independently. While most last-year residents managed to meet the targeted numbers for minor surgical procedures outlined in the logbook, they fell short of achieving the required numbers for major operations, such as hysterectomies or more complex laparoscopies. Although both trainees and trainers emphasized the significance of surgical training, the overall quality of the training was rated poorly, particularly by trainees. This was attributed to a high proportion of administrative tasks and a deficiency in teaching time within the operating theater. External fellowship and mentoring programs, as well as the implementation of regular, centralized reviews of residency training, were identified as potentially beneficial by both trainees and trainers.

CONCLUSION

The findings of this survey should serve as a wake-up call both within and outside of Germany, highlighting the importance of comprehensive and structured surgical training to enhance long-term patient care and increase satisfaction among obstetrics and gynecology trainees.

Stimmungsbild des ärztlichen Nachwuchses in der Frauenheilkunde und Geburtshilfe in Norddeutschland

Hintergrund

Der ärztliche Nachwuchs hat disruptive Effekte und macht auch vor dem Fach Frauenheilkunde und Geburtshilfe nicht halt. Noch fokussiert sich der Diskurs auf die Generation Y (1980–1994). Um dem Nachwuchs ein konstruktives Arbeitsumfeld zu bieten, drängt die Zeit. Es gilt, sich dessen Anforderungen an ein solches zu vergegenwärtigen.

Zielsetzung

Erfassen des Stimmungsbilds des ärztlichen Nachwuchses in der Frauenheilkunde und Geburtshilfe mit anschließender Ableitung praxisrelevanter Aspekte unter Berücksichtigung der künftig dominierenden Generation Z (1995–2009).

Methoden

Von Januar bis Oktober 2021 wurde eine deskriptive Querschnittserhebung des ärztlichen Nachwuchses ausbildender Kliniken im Fach Frauenheilkunde und Geburtshilfe durchgeführt. Es wurden 81 Fragen zu 6 Themen online abgefragt.

Ergebnis

Ausgewertet wurden 122 Fragebögen (n = 122): 28 % (n = 33) schätzen die Arbeitsbelastung als sehr hoch, 56 % (n = 67) als hoch ein. Zwei Drittel (n = 81) arbeiten wöchentlich 40–59 h. Den Anteil delegierbarer Tätigkeiten beziffern 67 % (n = 80) auf > 25 %. 88 % (n = 105) verbringen 25–75 % der täglichen Arbeitszeit mit Dokumentieren. 92 % (n = 109) wünschen sich regelmäßige Ober- bzw. Chefarztvisiten, 81 % (n = 95) beurteilen die Weiterbildung schlechter als gut. Für 32 % (n = 38) besteht ein ausgeglichenes Verhältnis zwischen Gesundheit und Beruf, 25 % (n = 29) beurteilen die Arbeitsbedingungen als familienfreundlich, und 88 % (n = 102) wären bereit, bei anhaltender Unzufriedenheit den Arbeitgeber zu wechseln.

Schlussfolgerung

Den Nachwuchs dominieren Forderungen nach Weiterbildung, Teilzeit, Sinnhaftigkeit, Vereinbarkeit von Familie und Beruf, Wertschätzung und Selbstfürsorge. Lösungskonzepte, um diesen gerecht zu werden, stünden zur Verfügung.

Zusatzmaterial online

Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00129-022-04942-5) enthalten.

A Web-Based Survey Assessing the Attitudes of Health Care Professionals in Germany Toward the Use of Telemedicine in Pregnancy Monitoring: Cross-Sectional Study

Background

The demand for fetal monitoring and constant reassurance is high in pregnant women. Consequently, pregnant women use various health apps and are more likely to visit emergency departments due to subjective but nonurgent complaints. However, electronic health (eHealth) and mobile health (mHealth) solutions are rarely used to prevent nonurgent emergency consultations. To implement modern care solutions, a better understanding of the attitudes, fears, and hopes of health care professionals toward eHealth and mHealth is needed.

Objective

The aim of this study was to investigate the attitudes of health care professionals in obstetrics toward telemedicine.

Methods

A quantitative Web-based survey on health care professionals in obstetrics in Germany was conducted. The participants included nurses, midwives, and physicians of all age groups and job positions working in hospitals that provide various levels of health care. The questionnaire comprised 24 questions about the characteristics of the study population, views about emergency consultations in obstetrics, attitude toward telemedicine, job satisfaction, and sleeping behavior.

Results

In total, 244 health care professionals participated in the Web-based survey. In general, health care professionals were skeptical (170/233, 72.9%) about the use of telemedicine in obstetrics; however, 55.8% (130/233) recognized its potential. Moreover, 72% (62/86) of physicians were optimistic in using apps for pregnancy monitoring, whereas 36.1% (47/130) of nonphysicians (P<.001) were not. Significantly, more nonphysicians rejected such developments (75/130, 57.7% rejected) compared with physicians (24/86, 28%; P<.001). We also found that obstetricians with more than 10 years of work-experience are more skeptical; however, approximately 49% (18/37) of them believed that telemedicine could reduce nonurgent emergency consultations, whereas 73.2% (106/145) of obstetricians with less than 5 years of experience (P=.01) thought otherwise. Our survey revealed a high job satisfaction and a prevalence of regular sleeping problems of 45.9% (91/198) among health care professionals in obstetrics. Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts per month (P=.77 and P=.99, respectively). Yet, 56.6% (112/198) of the survey participants thought they would be happier with their job if they had to work fewer night shifts per month.

Conclusions

Our study reveals an ambivalent attitude toward the use of telemedicine among health care professionals in obstetrics in Germany at the moment. Efforts to promote the use of telemedicine should focus on nurses and midwives because these groups are the most skeptical. By contrast, particularly young physicians recognize the potential of apps in patient care and would like to use such technology in pregnancy monitoring.