Career choice influences in Australian anaesthetists

Intentions and Barriers to Research Activities among Australian and New Zealand anaesthetists: A Survey

A voluntary, anonymous, cross-sectional online survey was conducted among 997 Fellows of the Australian and New Zealand College of Anaesthetists, using an electronic questionnaire. Details about their demographics, employment, research experience and barriers they had encountered, their perception about research and their future intentions to participate in research, were collected. The survey response rate was 24.6%. At the time of the survey, 29% of the survey respondents were involved in research. Respondents currently involved in research were more likely to be practising at a tertiary hospital, to have previously presented at conferences, to believe in the importance of research and to intend to undertake further research training ( P <0.05). Time constraints were the most commonly cited reason for not currently performing research. Those who were involved in research spent about 6.3 more hours per week in public practice than those who were not ( P=0.012) and had about 4.4 more hours per week of non-clinical time ( P <0.001). In terms of barriers encountered during previous projects, 91% of the respondents cited methodological issues, which included complicated ethics approval processes, difficulty in coordinating teams or recruiting participants, non-compliant patients and difficulty in publishing. Sixty-three percent of those surveyed believed more exposure to research activities during training would increase the number of anaesthetists involved in research and scholarly activities. Through this survey, we have identified several areas that, if satisfactorily addressed, could enhance interest and participation in research amongst anaesthetists in Australia and New Zealand.

[Reasons residents choose to specialize in anesthesiology and postoperative critical care in the autonomous community of Madrid]

OBJECTIVES

Our main objective was to determine the reasons why residents chose to specialize in anesthesiology and postoperative critical care in the autonomous community of Madrid. We also wished to know if prior contact with this specialty influenced their choice, if those who chose it as a second specialization differed from those who were doing a first residency, what expectations the residents had and if they had been met, and if they were satisfied with their training.

MATERIAL AND METHODS

Survey of all residents in anesthesiology and postoperative critical care medicine in the community of Madrid between November 2008 and February 2010. The questionnaire items covered demographic data, prior specialty training, undergraduate contact with the specialty, reasons for choosing this specialty (technical, social, or employment-related interests), satisfaction, and expectations met.

RESULTS

We received 89 valid questionnaires, a sample that represented 35% of the residents. The reasons expressed most often were learning and performing techniques (97.8%); that the specialty was dynamic, with broad theoretical and practical content (98.9%), and an interest in providing critical care (93.3%). These 3 reasons were considered important or very important by most of the respondents; 55.8% considered that learning and carrying out techniques was the most important reason. All the respondents who had previously done specialty training said they were dissatisfied. Prior contact with the specialty was associated with having different reasons and interests, such as an interest in pain (F = .037) or emulating a role model (P = .014).

CONCLUSIONS

The specialty's mix of theoretical and practical content and the chance to perform techniques and provide critical care are the features the residents find most attractive. Residents who already have another specialty are less satisfied and their expectations are not as well met.

Good clinical teachers likely to be specialist role models: results from a multicenter cross-sectional survey

CONTEXT

Medical educational reform includes enhancing role modelling of clinical teachers. This requires faculty being aware of their role model status and performance. We developed the System for Evaluation of Teaching Qualities (SETQ) to generate individualized feedback on previously defined teaching qualities and role model status for faculty in (non) academic hospitals.

OBJECTIVES

(i) To examine whether teaching qualities of faculty were associated with their being seen as a specialist role model by residents, and (ii) to investigate whether those associations differed across residency years and specialties.

METHODS & MATERIALS

Cross-sectional questionnaire survey amongst 549 Residents of 36 teaching programs in 15 hospitals in the Netherlands. The main outcome measure was faculty being seen as specialist role models by residents. Statistical analyses included (i) Pearson's correlation coefficients and (ii) multivariable logistic generalized estimating equations to assess the (adjusted) associations between each of five teaching qualities and 'being seen as a role model'.

RESULTS

407 residents completed a total of 4123 evaluations of 662 faculty. All teaching qualities were positively correlated with 'being seen as a role model' with correlation coefficients ranging from 0.49 for 'evaluation of residents' to 0.64 for 'learning climate' (P<0.001). Faculty most likely to be seen as good role models were those rated highly on 'feedback' (odds ratio 2.91, 95% CI: 2.41-3.51), 'a professional attitude towards residents' (OR 2.70, 95% CI: 2.34-3.10) and 'creating a positive learning climate' (OR 2.45, 95% CI: 1.97-3.04). Results did not seem to vary much across residency years. The relative strength of associations between teaching qualities and being seen as a role model were more distinct when comparing specialties.

CONCLUSIONS

Good clinical educators are more likely to be seen as specialist role models for most residents.

Part-time clinical anesthesia practice: a review of the economic, quality, and safety issues

Part-time clinical practice in anesthesia is increasing due to the feminization and the aging of the medical workforce, as well as the arrival of generations X and Y to the health care workforce. Recruiting the best and brightest physicians requires accommodating their needs and interests, as well as retaining older workers who wish to reduce their hours as they approach retirement. This article discusses steps to help departments or groups optimally manage the part-time anesthesia workforce.

Enjoying work or burdened by it? How anaesthetists experience and handle difficulties at work: a qualitative study †

BACKGROUND

The aim of this study was to explore difficulties at work from anaesthetists' own perspective and to examine how anaesthetists handle and cope with situations that are perceived as difficult and potentially stressful.

METHODS

Two sets of interviews were conducted with 19 specialist anaesthetists in Sweden. The first set of interviews aimed at finding how the anaesthetists experienced difficulties at work. It consisted of in-depth interviews based on one open-ended question. We analysed the interviews with a phenomenological method, looking for themes in anaesthetists' descriptions of difficulties at work. In the second set, the interviews were semi-structured with open-ended questions, based on themes found in the first interview set. These interviews aimed at exploring how the interviewees described their ways of handling difficulties and how they coped with potentially stressful situations.

RESULTS

Analysis of the first set of interviews resulted in five themes, describing how the anaesthetists experienced difficulties at work. All interviewees talked about difficulties related to more than one of the themes. The second set of interviews revealed two main categories of ways of handling difficulties. First, problem solving consisted of descriptions of methods for handling difficult situations which aimed at solving problems, and second, coping strategies described ways of appraising potentially stressful situations that minimized stress, despite the problem not being solved.

CONCLUSIONS

The anaesthetists interviewed in this study maintained that they enjoyed work and could see no external obstacles to doing a good job. They had arrived at a reconciliation of their work with its inherent difficulties and problems. Getting access to their coping strategies might help young anaesthetists to come to terms with their work.

Being a young and inexperienced trainee anesthetist: a phenomenological study on tough working conditions

BACKGROUND

Physicians at the beginning of their specialist education have been reported to be especially exposed to stress and difficult working conditions. Considerable worry has also been caused by reports about anaesthetists dying at a younger age than other specialists as well as by reports about higher than average suicide rates among anaesthetists. Maybe as a consequence, many young doctors are reluctant to choose anaesthesiology as their future specialty. The aim of this study was to investigate what difficulties trainee anaesthetists experience at work.

METHODS

Nineteen trainee anaesthetists in six Swedish hospitals were interviewed. Phenomenological analysis of the interview text was performed.

RESULTS

All trainees had experienced considerable, sometimes extreme demands at work. Most of them often felt insufficient and inadequate and had problems with the professional role. Support from consultants was sometimes lacking. Some trainees expressed deep feelings of loneliness and helplessness in difficult clinical situations.

CONCLUSIONS

This study shows that trainee anaesthetists have to live up to high work demands, often with very little support. Because too much stress is an obstacle to professional learning, such working conditions are a hindrance to good specialist education. The first measure to be taken should be to ensure that all trainee anaesthetists always have easy access to senior cover.

Clinical teachers as role models: perceptions of interns and residents in a Lebanese medical school

OBJECTIVE

To identify the characteristics and learning impact of role models as perceived by interns and residents in an Arabic Middle Eastern country, Lebanon.

METHODS

A structured and self-administered questionnaire was sent to the cohort of interns (n = 34) and residents (n = 66) training in a Lebanese university hospital. The questionnaire contained pre-specified items related to professional and personal characteristics of positive and negative role models, as well as to the impact of these models on professional learning and career choices. Responders were asked to recognise and to rank-order the items associated to their identified models.

RESULTS

A total of 88 responders (97%) had positive role models and 87 responders (96%) had negative role models in their current training programme. Characteristics identified most frequently and ranked most highly by the trainees were related to clinical skills in positive role models and to inadequate humanistic and collaborative attitudes in negative models. Role modelling had a positive impact on the achievement of clinical skills for 55% of the responders, and on the acquisition of humanistic and collaborative attitudes for 30% of them. Thirty-eight per cent of the trainees were influenced by their role models in the choice of their specialities. Responses were generally comparable between levels of training and between medical and surgical specialities.

CONCLUSION

Clinical teachers, practising in a non-occidental cultural and medical learning environment, are considered very frequently as role models by their interns and residents and have a positive impact on their professional learning and career choices. Strategies to reinforce role modelling are needed in Lebanon, in order to pass a broad spectrum of professional values to our students.