Stress symptoms and burnout in obstetric and gynaecology residents

OBJECTIVE: This study was designed to examine the burnout syndrome among residents in obstetrics and gynaecology in Spain, and to analyse the predisposing factors for this condition. SETTING: Eight Spanish University hospitals. SAMPLE: A total of 162 residents representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency were asked to take part in this survey. METHODS: The Maslach Burnout Inventory was mailed to each resident of eight Spanish hospitals representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency. Burnout was defined as a high score on the emotional exhaustion or depersonalisation subscores, according to validated standard cutoff values. The demographic and predisposing work factors were noted for each participant using a self-reported questionnaire. A binary logistic regression model was constructed from all predisposing factors as covariates for the prediction of the burnout syndrome. RESULTS: Sixty-seven percent of the 162 eligible residents returned their questionnaires within a 3-month period. Of those, 58% fulfilled the criteria for the burnout syndrome. In the multivariate analysis, marital status and workload in office practice were found to be significant predisposing factors. Single marital status increased the odds ratio for burnout by 5.2 (95% CI 1.3-21). For every extra ten patients attended in the office per week, the odds ratio for burnout increased by 1.25 (95% CI 1.0-1.5). A stratified multivariate subanalysis showed that this risk remained significant only in the group of residents without staff supervision with an odds ratio of 2.1 (95% CI 1.3-2.9). CONCLUSION: The prevalence of the burnout syndrome during obstetrics and gynaecology residency is high. Single marital status and workload in office practice without staff supervision are significant predisposing factors.     

Injuries to emergency medicine residents on ems rotations

Objectives. To study the incidence and nature of injuries sustained by emergency medicine (EM) residents during EMS rotations, and steps taken at EM residency programs to increase resident safety during field activities. Methods. An eight-question survey form was mailed to all 114 U.S. EM residency directors, with a second mailing to nonresponders eight weeks after the initial mailing. Results. A total of 105 surveys were returned (92%). Six surveys were from new programs whose residents have not yet rotated on EMS. These were excluded from further analysis, leaving 99 programs. Of these, 91 (92%) reported no injuries. One EM resident died in a helicopter crash in 1985. Seven other injury events were reported: 1) facial lacerations, rib fractures, and a shoulder injury in an ambulance accident; 2) an open finger fracture (crushed by a backboard); 3) contusions and a concussion when an ambulance was struck by a fire engine; 4) a groin pull sustained while entering a helicopter; 5) bilateral metatarsal fractures in a fall; 6) rib fractures, a pneumothorax, and a concussion in an ambulance accident; and 7) “minor injuries” sustained in a crash while responding to a scene in a program-owned response vehicle. Actions taken at residency programs to reduce the risk of injury include the use of ballistic vests (four programs), requiring helmets on flights (five programs), and changing flight experience from mandatory to optional (two programs). Ten programs (10%) reported using ground scene safety lectures, and nine programs (15% of those offering flights) reported various types of flight safety instruction. Sixty-nine programs (70%) reported no formal field safety training or other active steps to increase resident safety on EMS rotations. Conclusions. Injuries sustained by EM residents during EMS rotations are uncommon but nontrivial, with several serious injuries and one fatality reported. The majority of EM residency programs have no formal safety training programs for EMS rotations.     

专业素养培训对本科实习护生临床实践行为及专业承诺的影响

目的探讨专业素养培训对本科实习护生临床实践行为及职业承诺的影响。方法对341名本科实习护生实施专业素养培训,包括岗前职业教育、职业技能培训、双导师负责制、护生管床制、实习大讲堂、护生风采展示。实习结束时采用临床实践行为问卷、护理专业承诺问卷进行调查。结果本科实习护生临床实践行为得分为3.81±0.65,护理专业承诺得分为84.67±13.74,显著高于国内常模(P<0.05,P<0.01)。结论专业素养培训有助于培养具有较高临床实践行为水平及稳定专业承诺意向的本科护生。     

医学影像专业医学影像诊断学见习教学模式初探

目的探索适合于医学影像专业医学影像诊断学的见习教学模式。方法将我校2004级医学影像专业五年制本科学生随机分成胶片见习教学组、多媒体见习教学组和多媒体与病例讨论结合见习教学组,分别进行见习带教,每章结束前对学生进行测试,共进行了8次阅片测试和1次期终综合能力测试。结果多媒体与病例讨论结合见习教学组各次阅片测试成绩及期终综合阅片能力测试成绩均高于其他两组,且存在显著性差异(P<0.05)。结论多媒体与病例讨论结合见习教学法,可以更好的提高学生的专业实践技能,是适合医学影像专业医学影像诊断学的见习教学模式。     

浅析实习医生的临床自我保护

初次接触临床诊治工作,缺乏自我保护意识,对院内感染的危害性认识不足,不熟悉诊疗操作技术及与病人和谐地交流沟通的经验,是实习医生容易遭受感染或伤害的主要原因。而减少或避免被伤害的有效措施则包括:增强自我健康保护意识;掌握正确的自我保护技术,培养良好的工作习惯;遵守诊疗规程,提高操作技能;充实医学伦理及法律知识,树立正确的道德法制观念。     

引入PDCA循环 加强实习教学管理

目的：加强临床实习教学过程管理，提高军队医院教学质量。方法：引入美国统计质量专家戴明提出的PDCA循环，改革临床实习教学管理模式。结果：实习教学管理工作步入高效、有序、规范的轨道，实习教学质量明显提高。结论：先进的教学管理模式是增强学生素质，提高教学质量的前提和关键。