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Are long hours and hard work detrimental to end-clerkship examination scores?

AMERICAN JOURNAL OF SURGERY 1999年第2期177卷 132-135页

作者： Gerhardt, JD Filipi, CJ Watson, P Tselentis, R Reeves, J Creighton Univ Sch Med Dept Surg Omaha NE 68131 USA

BACKGROUND: Third-year medical students' complaints focus on the number of hours worked and subsequent lack of study time among three general surgery blocks. We hypothesize that this difference between the surgical blocks does not adversely influence student examination scores. METHODS: Student scores for the academic years 1996-97 to 1997-98 for the National Board of Medical Examiners (NBME) surgery subtests were compiled. A comparison of two "slow"' general surgery blocks (B/C) with one "busy" block (A) was made using a two-tailed t test. A multiple regression analysis was also employed. Finally, United Stales Medical Licensing Examination (USMLE) part I scores were used to determine equivalency of groups. RESULTS: NO significant difference existed between block A and blocks B/C in USMLE part I and NBME (P = 0.35 and 0.16 respectively). However, USMLE and rotation sequence influenced NBME scores (P < 0.001). CONCLUSION: The data suggest that no difference exists in examination scores between students assigned to a busy general surgery block versus those students assigned to slow blocks.(C) 1999 by Excerpta Medica, Inc.

关键词：临床实习教育考核/统计学和数值数据回归分析时间因素美国工作负荷量/统计学和数值数据人类

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A study of the workforce in emergency medicine: 1999

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ANNALS OF EMERGENCY MEDICINE 2002年第1期40卷 3-15页

作者： Moorhead, JC Gallery, ME Hirshkorn, C Barnaby, DP Barsan, WG Conrad, LC Dalsey, WC Fried, M Herman, SH Hogan, P Mannle, TE Packard, DC Perina, DG Pollack, CV Rapp, MT Rorrie, CC Schafermeyer, RW Oregon Hlth Sci Univ Dept Emergency Med Portland OR 97201 USA Amer Coll Emergency Phys Irvine CA USA Lewin Grp Falls Church VA USA Mt Sinai Sch Med Dept Emergency Med New York NY USA Univ Michigan Dept Emergency Med Ann Arbor MI 48109 USA St Joseph Hosp Dept Emergency Med Denver CO USA Robert Wood Johnson Univ Hosp Dept Emergency Med New Brunswick NJ USA Amer Coll Emergency Phys Washington DC USA Wesley Long Moses Cone Hosp Dept Emergency Med Greensboro NC USA Baylor Univ Med Ctr Dept Emergency Med Dallas TX USA Univ Virginia Hlth Sci Ctr Dept Emergency Med Charlottesville VA USA Penn Hosp Dept Emergency Med Philadelphia PA 19107 USA Washington Univ Sch Med & Hlth Dept Emergency Med Washington DC USA Carolinas Med Ctr Dept Emergency Med Charlotte NC 28203 USA

Study objective: We estimate the total number of physicians practicing clinical emergency medicine during a specified period, describe certain characteristics of those individuals to estimate the total number of full-time equivalents (FTEs) and the total number of individuals needed to staff those FTEs, and compare the data collected with those data collected in 1997. Methods: Data were gathered from a survey of a random sample of 2,153 hospitals drawn from a population of 5,329 hospitals reported by the American Hospital Association as having, or potentially having, an emergency department. The survey instrument addressed items such as descriptive data on the institution, enumeration of physicians in the ED, and the total number of physicians working during the period from June 6 to June 9, 1999. Demographic data on the individuals were also collected. Results: A total of 940 hospitals responded (a 44% return rate). These hospitals reported that a total of 6,719 physicians were working during the specified period, or an average of 7.85 persons scheduled per institution. The physicians were scheduled for a total of 347,702 hours. The average standard for FrE was 40 clinical hours per week. This equates to 4,346 FTEs or 5.29 FTEs per institution. The ratio of persons to FrEs was 1.48:1. With regard to demographics, 83% of the physicians were men, and 82% were white. Their average age was 42.6 years. As for professional credentials, 42% were emergency medicine residency trained, and 58% were board certified in emergency medicine;50% were certified by the American Board of Emergency Medicine. Conclusion: Given that there are 5,064 hospitals with EDs and given that the data indicate that there are 5.35 FTEs per ED, the total number of FTEs is projected to be 27,067 (SE=500). Given further that the data indicate a physician/FTE ratio of 1.47:1, we conclude that there are 39,746 persons (SE=806) needed to staff those FTEs. When adjusted for persons working at more than on

关键词：美国医院协会证明/统计学和数值数据急救医学/教育急诊室医院实习医师和住院医师职务/统计学和数值数据医务人员医院/标准医务人员医院/供应和分配人员配备和时间安排/统计学和数值数据专业场所/统计学和数值数据前瞻性研究薪金和附加福利/统计学和数值数据美国工作负荷量/统计学和数值数据成年人女(雌)性人类男(雄)性中年人

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Views of academic dentists about careers in academic dentistry in the United Kingdom.

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BRITISH DENTAL JOURNAL 2000年第3期188卷 154-159页

作者： Goldacre, M Lee, P Stear, S Sidebottom, E Richards, R Univ Oxford Inst Hlth Sci Unit Healthcare Epidemiol UK Med Careers Res Grp Oxford OX3 7LF England Univ Oxford Merton Coll Oxford OX1 4JD England Univ Oxford St Hildas Coll Oxford OX4 England

The aim of this paper is to report the views of academic dentists about careers in academic dentistry assessed by method of a postal questionnaire survey. The subjects of the survey were dentists in academic posts in the United Kingdom. The incentives in pursuing an academic career which respondents rated most highly were the opportunity to teach and the variety of work in an academic career. The greatest disincentives were competing pressures from service work, teaching and research, and the difficulty of getting research grants. Many would like to spend more time on research and less on service work and teaching. The length of time required for training, and the quality of training, was a concern, particularly for junior academics. Most respondents rated the enjoyment of their job highly but scored much lower on satisfaction with the time their job left for domestic and leisure activities. By contrast with academic medicine, in academic dentistry there is typically greater emphasis on teaching and less on research. In conclusion, the balance of activities in academic posts, particularly between service work, teaching and research, needs to be regularly reviewed. The development of a more structured training programme for junior academics, which does not disadvantage academic dentists when compared with their NHS colleagues, may be required.

关键词：医务工作者的态度职业选择卡方分布牙医师/心理学牙医师/统计学和数值数据牙医师女/心理学牙医师女/统计学和数值数据教育牙科/统计学和数值数据职业满意统计学非参数工作负荷量/统计学和数值数据女(雌)性人类男(雄)性

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Impact of dedicated trauma lists on a maxillofacial surgical service

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BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 2000年第5期38卷 492-495页

作者： Edmondson, MJ Cousin, GCS Lowry, JC Brownrigg, P Morton, ME Blackburn Royal Infirm E Lancs Maxilofacial Serv 4Bs Blackburn Lancs England

In 1995, the maxillofacial surgical inpatient services in East Lancashire were centralized in Blackburn Royal Infirmary, and twice-weekly operating lists dedicated to maxillofacial trauma were established. We examined the non-elective workload for three-month periods before and after trauma lists became available to find out the proportion of non-elective operations done out of normal working hours. Although there was an increase in the total number of non-elective patients after centralization, day-time trauma lists allowed a reduction in the proportion of operations performed out of normal working hours. Fewer trauma cases were added to elective lists. Trauma lists allow the unit to comply with the recommendations of both NCEPOD and the Calman report, in that they maximize training opportunities for all staff and facilitate both audit and research. (C) 2000 The British Association of Oral and Maxillofacial Surgeons.

关键词：工作负荷量/统计学和数值数据

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Use of a self-selected scheduling method in a large academic emergency medicine group

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ANNALS OF EMERGENCY MEDICINE 2003年第5期41卷 653-658页

作者： Binder, DS Crandall, CS Hauswald, M Univ New Mexico Dept Emergency Med Albuquerque NM 87131 USA

We describe a method for scheduling shifts in a large academic emergency medicine group. The method starts with a survey of the faculty to assign shift equivalent values to each of the 13 different shifts used during the week. A weekday day shift is assigned a value of 1.0, and the shifts range in value up to 2.1 units. Each faculty member is then assigned a shift allocation for the academic year equally divided among the various shift types. Faculty members can request reallocation of shift types on the basis of the individual shift equivalent values. Once the number of the different shifts are allocated as required by the schedule, a lottery is held whereby individual faculty members choose specific shifts in turn for the upcoming year. The lottery selection is done by the faculty members accessing a common server from their office computers during a specified period. The lottery process continues until all shifts are filled. The creation of shift equivalent values facilitates the initial allocation of shifts and subsequent trades between faculty members.

关键词：医学科学研究中心急诊室医院/统计学和数值数据全体教工医学院校/统计学和数值数据人员配备和时间安排/统计学和数值数据工作负荷量/统计学和数值数据人类

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Were there enough physicians in an emergency department in the affected area after a major earthquake? An analysis of the Taiwan Chi-Chi earthquake in 1999

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ANNALS OF EMERGENCY MEDICINE 2001年第5期38卷 556-561页

作者： Chen, WK Cheng, YC Ng, KC Hung, JJ Chuang, CM China Med Coll Hosp Dept Emergency Med Taichung 404 Taiwan

Study objective: The purpose of this study was to evaluate physician manpower and mobilization in an urban emergency department receiving patients after a major earthquake. Methods: Patient charts were reviewed. The workload of physicians was assessed semiquantitatively before and after a major earthquake, The physicians' mobilization in the postearthquake emergency response was assessed by using a confidential questionnaire. Results: In the 3 days after the earthquake, 566 patients with earthquake-related illnesses or injuries were sent to the urban ED. Three hundred one (53.2%) patients arrived within the initial 10 hours. In the initial hours, there was no significant difference between the number of patients per physician per hour before and after the earthquake. Workloads of wound treatment and advanced life support procedures were significantly higher after the earthquake compared with before the earthquake, during the first to sixth hour and second to fifth hour, respectively. Sixty-five percent of the hospital's physicians did not assist in either the ED or in any other parts of the hospital in the initial 6 hours after the earthquake. Conclusion: The number of physicians in the ED was insufficient in the initial hours after the earthquake because of the sudden influx of a large number of patients. Future disaster planning must address the issue of physicians' behavior with regard to their priorities immediately after a major earthquake and include greater provision for efficient mobilization of physicians.

关键词：急诊室医院/人力医院大学/人力医院市区/人力生命支持疗法/人力多处创伤/死亡率自然灾害医师/供应和分配台湾工作负荷量/统计学和数值数据女(雌)性人类男(雄)性

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The emergency medicine workforce study: More questions than answers

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ANNALS OF EMERGENCY MEDICINE 2002年第1期40卷 16-18页

作者： Augustine, JJ Kellermann, AL Emory Univ Sch Med Dept Emergency Med Atlanta GA 30322 USA

[Augustine JJ, Kellermann AL. The emergency medicine workforce study: more questions than answers. Ann Emerg Med . July 2002;40:16-18.]

关键词：文化多样性急救医学/组织和管理急救医学/发展趋势急诊室医院卫生政策实习医师和住院医师职务/统计学和数值数据职业满意医务人员医院/组织和管理医务人员医院/供应和分配诊疗工作管理医学/组织和管理美国工作负荷量/统计学和数值数据女(雌)性人类男(雄)性

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The Impact of Informal Care Giving on Labor Force Participation by Rural Farming and Nonfarming Families

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The Journal of Rural Health 1994年第4期10卷 266-272页

作者： Horwitz, Mary E. Rosenthal, Thomas C. Rural Health Research Center Department of Family Medicine State University of New York in Buffalo New York United States Department of Family Medicine State University of New York in Buffalo Buffalo New York United States

Using data from the National Survey of Families and Households, 1987, this study contrasts urban versus rural, and farm versus rural nonfarm informal care givers of the elderly and disabled to illustrate the conflicts that each group experiences when combining work and care giving. Women are the primary care givers in both rural and urban areas. Rural care givers spent more time providing care than urban caregivers, whether the dependent resided in the care giver's home or elsewhere in the community. A moderate difference existed in the number of hours care givers spent at work, although the rural care giver's spouses worked significantly more hours than urban spouses. Rural nonfarm care givers spent more hours caring for individuals residing in their communities, while farm caregivers spent the most time in household‐related activities when caring for someone in their homes. In‐home activity decreased the number of hours spent at work, while community care giving did not. Copyright © 1994, Wiley Blackwell. All rights reserved

关键词：医疗护理提供者/统计学和数值数据卡方分布数据收集残疾人就业家庭护理(非专业)/人力纽约农村人口/统计学和数值数据社会经济因素市区人口/统计学和数值数据工作负荷量/统计学和数值数据青少年老年人女(雌)性人类男(雄)性

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Working conditions in home care: A survey of washington state’s home care workers

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Home Health Care Services Quarterly 1994年第4期14卷 37-48页

作者： Hayashi, Reiko Gibson, John W. Weatherley, Richard A. University of Washington School of Social Work WA United States School of Social Work University of Washington Seattle WA 98195 4101 15th Avenue NE JH-30 United States

Home care services make it possible for millions of older Americans to continue living in the community. Such services may enhance the recipients’ quality of life while providing essential respite to family caregivers. But while there has been increasing recognition of the burden borne by the predominantly female family caregivers, there has been less attention to the plight of the home care workforce. With the growth of the home care industry, the burden of care has to some extent shifted from one category of female caregivers to another. This paper, based on a survey of 16 agencies and 1,900 workers, examines the employment conditions of home care workers in Washington state. The study reveals a pattern of harsh working conditions, low wages, and few benefits. The findings raise questions about the ethics and efficacy of government policies that are based on the exploitation of home care workers. © 1994 Taylor & Francis Group, LLC.

关键词：数据收集人口统计学雇员不满/统计学和数值数据就业/经济学就业/统计学和数值数据家庭医疗保健服务/经济学家庭医疗保健服务/人力家庭医疗保健服务/统计学和数值数据在职培训/统计学和数值数据薪金和附加福利/统计学和数值数据华盛顿妇女就业/统计学和数值数据工作负荷量/统计学和数值数据女(雌)性人类中年人

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Speech and language therapy caseloads in seven districts in the UK.

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Journal of management in medicine 1999年第1期13卷 23-32页

作者： van der Gaag, A. McLoone, P. Reid, D. Department of Speech and Language Therapy University of Strathclyde Scotland United Kingdom

This paper provides managers and clinicians with an analysis of routine data collected by seven speech and language therapy services in the UK. Managers in seven districts in the UK of varying size and location were asked to provide information on referrals, waiting times and attendances during the six month period, and to give a breakdown of the types of intervention offered and type of clients seen. These data were aggregated and comparisons were made with existing data on speech and language therapy services. The results revealed considerable variations in prevalence, staffing ratios and client management practices. The implications for service planning are discussed.

关键词：人员配备和时间安排/统计学和数值数据转诊和会诊/利用言语疗法/组织和管理言语疗法/统计学和数值数据公费医疗/利用时间和运动研究预约名单工作负荷量/统计学和数值数据男(雄)性

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