Swipe om te navigeren naar een ander artikel
Following the introduction of work-hour restrictions, residents’ workload has become an important theme in postgraduate training. The efficacy of restrictions on workload, however, remains controversial, as most research has only examined objective workload. The purpose of this study was to explore the less clearly understood component of subjective workload and, in particular, the factors that influenced residents’ subjective workload.
This study was conducted in Japan at three community teaching hospitals. We recruited a convenience sample of 31 junior residents in seven focus groups at the three sites. Audio-recorded and transcribed data were read iteratively and analyzed thematically, identifying, analyzing and reporting themes within the data and developing an interpretive synthesis of the topic.
Seven factors influenced residents’ subjective workload: (1) interaction within the professional community, (2) feedback from patients, (3) being in control, (4) professional development, (5) private life, (6) interest and (7) protected free time.
Our findings indicate that residents who have good interaction with colleagues and patients, are competent enough to control their work, experience personal development through working, have greater interest in their work, and have fulfilling private lives will have the least subjective workload.
Philibert I, Friedmann P, Williams WT, ACGME Work Group on Resident Duty Hours. Accreditation Council for Graduate Medical Education. New requirements for resident duty hours. JAMA. 2002;288(9):1112–4. CrossRef
The ACGME 2011 Duty Hour Standard. acgme.org. http://www.acgme.org/acgmeweb/Portals/0/PDFs/jgme-monograph.pdf. Accessed 31 May 2014.
Clarke RT, Pitcher A, Lambert TW, Goldacre MJ. UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis. BMJ Open. 2014;4(2):e004390. CrossRef
Landrigan CP, Rothschild JM, Cronin JW, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med. 2004;351(18):1838–48. CrossRef
Golub JS, Weiss PS, Ramesh AK, Ossoff RH, Johns MM. Burnout in residents of otolaryngology-head and neck surgery: a national inquiry into the health of residency training. Acad Med. 2007;82(6):596–601. CrossRef
Goitein L, Shanafelt TD, Wipf JE, Slatore CG, Back AL. The effects of work-hour limitations on resident well-being, patient care, and education in an internal medicine residency program. Arch Intern Med. 2005;165(22):2601–6. CrossRef
Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL. The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg. 2006;243(6):864–71. (discussion 871–5). CrossRef
Shwenk TL. Residents’ work hours. N Engl J Med. 2009;361(9):928. CrossRef
Schumacher DJ, Slovin SR, Riebschleger MP, Englander R, Hicks PJ, Carraccio C. Perspective: beyond counting hours: the importance of supervision, professionalism, transitions of care, and workload in residency training. Acad Med. 2012;87(7):883–8. CrossRef
Kozu T. Medical education in Japan. Acad Med. 2006;81(12):1069–75. CrossRef
Teo A. The current state of medical education in Japan: a system under reform. Med Educ. 2007;41(3):302–8. CrossRef
Hirotaka Onishi. Postgraduate training model programs. [in Japanese]. Tokyo: Shinoharashinsha Publishers; 2003.
Deshpande GA, Soejima K, Ishida Y, et al. A global template for reforming residency without work-hours restrictions: decrease caseloads, increase education. Findings of the Japan Resident Workload Study Group. Med Teach. 2012;34(3):232–9. CrossRef
Barbour RS. Making sense of focus groups. Med Educ. 2005;39(7):742–50. CrossRef
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. CrossRef
Thomas NK. Resident burnout. JAMA. 2004;292(23):2880–9. CrossRef
Nyssen AS, Hansez I, Baele P, Lamy M, De Keyser V. Occupational stress and burnout in anaesthesia. Br J Anaesth. 2003;90(3):333–7. CrossRef
Burks DJ, Kobus AM. The legacy of altruism in health care: the promotion of empathy, prosociality and humanism. Med Educ. 2012;46(3):317–25. CrossRef
Bishop JP, Rees CE. Hero or has-been: is there a future for altruism in medical education? Adv Health Sci Educ Theory Pract. 2007;12(3):391–9. CrossRef
Nishigori H, Harrison R, Busari J, Dornan T. Bushido and medical professionalism in Japan. Acad Med. 2014;89(4):560–3. CrossRef
- Beyond work-hour restrictions: a qualitative study of residents’ subjective workload
Gautam A. Deshpande
- Bohn Stafleu van Loghum