How do attendings perceive housestaff autonomy? Attending experience, hospitalists, and trends over time.
How do attendings perceive housestaff autonomy? Attending experience, hospitalists, and trends over time.
复制标题
主治人员如何看待住宿人员的自主权？
DOI：
10.1002/jhm.2016
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Arora,VineetM
中科院分区：
文献类型：
--
作者：
Martin,ShannonK;Farnan,JeanneM;Mayo,Ainoa;Vekhter,Benjamin;Meltzer,DavidO;Arora,VineetM
毕业监督是必要的居民进步到独立，但目前尚不清楚是什么因素影响了主治医生对家政服务人员自主性的看法。目的：确定主治医生的特征和长期趋势是否与主治医生对家政服务人员自主性的看法的变化有关。方法：对2001年至2008年收集的月度调查数据进行次级数据分析。参与者在一个学术性的三级保健中心对住院医生和非住院医生进行内科教学服务的调查，测量他们对实习医生决策和住院医生自主权的看法。与职业生涯初期的主治医师相比，有经验的主治医师认为更多的实习医师参与决策（比值比[OR]：2.16，95%置信区间[CI]：1.17 - 3.97，P =0.013）。与非住院医师相比，住院医师认为实习医师参与决策（OR：0.19，95%CI：0.06 - 0.58，P =0.004）和住院医师自主权（OR：0.27，95%CI：0.11 - 0.66，P =0.004）较少。住院医师和经验之间存在显着的相互作用;与早期职业住院医师相比，经验丰富的住院医师认为更多的实习决策（OR：7.36，95%CI：1.86 - 29.1，P =0.004）和住院医师自主权（OR：5.85，95%CI：1.75 - 19.6，P =0.004）。在长期趋势方面，与其他季节相比，学年的春季与更大的实习决策感知相关（OR：1.94，95%CI：1.18 - 3.19，P =0.009）。2003年住院医师值班时间限制与住院医师决策能力（OR：0.51，95%CI：0.29 - 0.87，P =0.014）和住院医师自主性（OR：0.49，95%CI：0.28 - 0.86，P =0.012）降低相关。医院医生对自主权和临床决策的看法不同，这取决于他们的主治经验。医院医学杂志2013;8：292-297。© 2013医院医学学会
BACKGROUNDGraduated supervision is necessary for residents to progress to independence, but it is unclear what factors influence attendings' perception of housestaff autonomy.OBJECTIVETo determine if attending characteristics and secular trends are associated with variation in attendings' perception of housestaff autonomy.DESIGNSecondary data analysis of monthly survey data collected from 2001 to 2008.SETTING/PARTICIPANTSAttending hospitalists and nonhospitalists on teaching internal medicine services at an academic tertiary care center.MEASUREMENTSAttendings' perception of intern decision making and resident autonomy.RESULTSResponse rate was 70% (514/738). Compared with early‐career attendings, experienced attendings perceived more intern involvement in decision making (odds ratio [OR]: 2.16, 95% confidence interval [CI]: 1.17‐3.97,P=0.013). Hospitalists perceived less intern involvement in decision making (OR: 0.19, 95% CI: 0.06‐0.58,P=0.004) and resident autonomy (OR: 0.27, 95% CI: 0.11‐0.66,P=0.004) compared with nonhospitalists. A significant interaction existed between hospitalists and experience; experienced hospitalists perceived more intern decision making (OR: 7.36, 95% CI: 1.86‐29.1,P=0.004) and resident autonomy (OR: 5.85, 95% CI: 1.75‐19.6,P=0.004) compared with early‐career hospitalists. With respect to secular trends, spring season of the academic year was associated with greater perception of intern decision making compared with other seasons (OR: 1.94, 95% CI: 1.18‐3.19,P=0.009). The 2003 resident duty‐hours restrictions were associated with decreased perception of intern decision making (OR: 0.51, 95% CI: 0.29‐0.87,P=0.014) and resident autonomy (OR: 0.49, 95% CI: 0.28‐0.86,P=0.012).CONCLUSIONSPerception of housestaff autonomy varies with attending characteristics and time trends. Hospitalists perceive autonomy and clinical decision making differently, depending on their attending experience.Journal of Hospital Medicine2013;8:292–297. © 2013 Society of Hospital Medicine
登录
查看更多内容
观点： 基于能力的研究生培训： 我们能否弥合理论与临床实践之间的差距？
影响因子：
7.4
作者：
ten Cate, Olle;Scheele, Fedde
通讯作者：
Scheele, Fedde
影响因子：
5.9
作者：
Farnan, Jeanne M.;Johnson, Julie K.;Arora, Vineet M.
通讯作者：
Arora, Vineet M.
信任、能力和导师在研究生培训中的作用。
DOI：
--
发表时间：
2006
期刊：
影响因子：
--
作者：
O. Cate
通讯作者：
O. Cate
影响因子：
120.7
作者：
Arora, Vineet M.;Georgitis, Emily;Meltzer, David O.
通讯作者：
Meltzer, David O.
ACGME 值班时间对主治医师教学和满意度的影响。
影响因子：
--
作者：
V. Arora;D. Meltzer
通讯作者：
D. Meltzer