某醫學中心一般外科住院醫師臨床醫學訓練時間分配之探討

A Time Study of General Surgical Residency Program in a Medical Center

周秋芳(Chiu-Fang Chou) ； 史麗珠(Lai-Chu See) ； 莊逸洲(Yi-Chou Chuang)

《台灣公共衛生雜誌》 20卷3期 (2001/06) Pp. 228-237

https://doi.org/10.6288/TJPH2001-20-03-08

摘要

Objectives: To study the workload of general surgical residents and examine how it varied with resident's seniority or day-night shift. Methods: Time spent in each activity was recorded by the residents themselves and compared using repeated measure ANOV A. Results: Ten residents participated in the study and 52 daily work-sheets were collected. (l) A resident worked 16.3 hours daily and patient care study and 52 daily work-sheets were collected. (l) A resident worked 16.3 hours daily and patient care made up the largest proportion of workload (11.1 hours). (2) Residents provided inpatient service to 9.8-19.3 patients each day, equivalent to 0.3-0.45 hours per inpatient per day. It increased with the resident's seniority but decreased for R4. (3) About five to eight operations were performed daily by each resident. The more senior the resident was, the longer the operation time. (4) The working hours were .14.6 hours per day for Rl and increased to 22.3 hours per day for R4' but show no statistical significance (p=.1564). Only R4'had administrative duties. (5) Night shift (20.1 hours) was significantly longer than day shift (13.4 hours) (p＜.000l). (6) Residents received only six minutes bedside teaching per inpatient per day. Conclusions: Operation learning was the major activity for surgical residents. Surgical residents often began day shift right after the night shift and day shift was usually overtime. The long working hours were not just stressful but also affected the quality of patient care. Our findings indicated an urgent need of reforming the traditional program of resident training.

關鍵字

住院醫師 ； 臨床教育 ； 訓練工時 ； 一般外科

並列摘要

Objectives: To study the workload of general surgical residents and examine how it varied with resident's seniority or day-night shift. Methods: Time spent in each activity was recorded by the residents themselves and compared using repeated measure ANOV A. Results: Ten residents participated in the study and 52 daily work-sheets were collected. (l) A resident worked 16.3 hours daily and patient care study and 52 daily work-sheets were collected. (l) A resident worked 16.3 hours daily and patient care made up the largest proportion of workload (11.1 hours). (2) Residents provided inpatient service to 9.8-19.3 patients each day, equivalent to 0.3-0.45 hours per inpatient per day. It increased with the resident's seniority but decreased for R4. (3) About five to eight operations were performed daily by each resident. The more senior the resident was, the longer the operation time. (4) The working hours were .14.6 hours per day for Rl and increased to 22.3 hours per day for R4' but show no statistical significance (p=.1564). Only R4'had administrative duties. (5) Night shift (20.1 hours) was significantly longer than day shift (13.4 hours) (p＜.000l). (6) Residents received only six minutes bedside teaching per inpatient per day. Conclusions: Operation learning was the major activity for surgical residents. Surgical residents often began day shift right after the night shift and day shift was usually overtime. The long working hours were not just stressful but also affected the quality of patient care. Our findings indicated an urgent need of reforming the traditional program of resident training.

並列關鍵字

Gresident ； clinical teaching ； training hours ； general surgery