Residência Multiprofissional em Saúde: (trans)formação para o SUS em comunidades quilombolas / Multiprofessional Residency in Health: (trans) formation for SUS in quilombola communities

Resumo A inserção e atuação profissional, no Sistema Único de Saúde (SUS), suscita debates e reflexões a respeito da formação de profissionais. Dessa forma, uma das estratégias para a obtenção de formação para o SUS são as Residências Multiprofissionais em Saúde (RMS). Neste estudo, objetivamos analisar as transformações no cotidiano dos serviços de saúde com a inserção do programa de Residência Multiprofissional em Saúde da Família, com ênfase na saúde da população do campo (RMSFC). Trata-se de um estudo de caso, de natureza qualitativa, tendo como participantes os atores que compõem o quadrilátero da formação, através de entrevistas semiestruturadas. Utilizamos a análise Discurso do Sujeito Coletivo (DSC), com o intuito de fazer o tratamento dos dados. Consideramos que esta pesquisa nos permitiu, ainda, visualizar as práticas e as transformações ocorridas nas Unidades Básicas de Saúde (UBS) após a inserção da RMSFC. Assim, temos informações importantes para refletir acerca de estratégias de formação de profissionais para trabalhar no SUS, especificamente no contexto da Saúde da População do Campo, contemplando comunidades quilombolas.

Abstract The insertion and professional performance in the Unified Health System (SUS), raises debates and reflections regarding the training of healthcare professionals. Thus, one of the strategies for obtaining training for the SUS is the Multiprofessional Residencies in Health (RMS). In this study, we aim to analyze the changes in the daily lives of health services with the insertion of the Multiprofessional Residency Program in Family Health, with an emphasis on the health of the rural population (RMSFC). It is a case study, of a qualitative nature, having as participants the actors that compose the quadrilateral of the formation, through semi-structured interviews. We used the Collective Subject Discourse (CSD) analysis, in order to process the data. We believe that this research also allowed us to visualize the practices and changes that occurred in the Basic Health Units (UBS) after the insertion of the RMSFC. Thus, we have important information to reflect on strategies for training professionals to work in SUS, specifically in the context of the Health of the Population of the Countryside, contemplating quilombola communities.

Clima de aprendizaje en residencias: adaptación transcultural y validación del cuestionario D-RECT al español / Learning climate in residencies: transcultural adaptation and validation of D-RECT questionaire into Spanish

Introducción. Medir el clima de aprendizaje es un aspecto relevante para estimar la calidad de los programas educativos. El Dutch Residency Educational Climate Test (D-RECT) es un instrumento ampliamente reconocido para ese propósito. Objetivo. Realizar la adaptación transcultural y validación del D-RECT al español para su utilización en Argentina. Métodos. A partir del cuestionario original, se realizó el proceso de traducción, y posterior demostración de evidencia sobre validez de contenido (equivalencia lingüística y cultural, y representatividad de los ítems dentro del constructo), proceso de respuesta (pretesteo y entrevistas a grupo piloto), estructura interna y confiabilidad (alfa de Cronbach, análisis factorial exploratorio y confirmatorio, y estudio G). Resultados. Cumplidas las etapas de adaptación transcultural, validación de contenido y del proceso de respuesta, 403 residentes de diferentes especialidades contestaron la versión en español del cuestionario e ingresaron al estudio. El análisis de propiedades psicométricas se realizó con los 392 cuestionarios completos, revelando evidencia favorable sobre la validez y confiabilidad del instrumento. Conclusión. Se realizó la adaptación transcultural del cuestionario D-RECT y se confirmó su adecuada validez y confiabilidad para evaluar el clima de aprendizaje en residencias de Argentina. (AU)

Introduction. Measuring the learning climate is a relevant aspect to estimate the quality of educational programmes. The Dutch Residency Educational Climate Test (D-RECT) is a widely recognised instrument for that purpose. Objective. To perform the cross-cultural adaptation and validation of the D-RECT into Spanish to be used in Argentina. Methods. Based on the original questionnaire, the translation process was carried out, and evidence of content validity (linguistic and cultural equivalence, and representativeness of the items within the construct), response process (pretesting and pilot group interviews), internal structure and reliability (Cronbach's alpha, exploratory and confirmatory factor analysis, and G study) was subsequently demonstrated. Results. Once the cross-cultural adaptation, content validation and response process validation stages were completed,403 residents from different specialties answered the adapted version of the questionnaire and entered the study. The analysis of psychometric properties was performed with 392 complete questionnaires, revealing favourable evidence for he instrument's validity and reliability. Conclusion. The cross-cultural adaptation of the D-RECT questionnaire was carried out and its adequate validity and to assess the learning climate in residences in Argentina was confirmed. (AU)

Maltrato en la formación médica: situación en las residencias de cardiología / Mistreatment In Medical Training: Situation In Cardiology Residences

RESUMEN Introducción: El maltrato se define como el comportamiento que hace que otra persona se sienta herida, desvalorizada o incompetente. Un cierto nivel de intimidación y humillación durante la formación se consideraba necesario para preparar al médico para una profesión difícil. Las condiciones en las que hoy se desarrollan las residencias médicas y la práctica profesional generan una alta prevalencia de burnout (agotamiento). Objetivo: Indagar la percepción que tienen los residentes de Cardiología sobre maltrato recibido y si reconocen haber incurrido en alguna conducta agraviante. Material y Métodos: Encuesta aplicada a residentes que asisten al Curso Bianual de Cardiología de la Sociedad Argentina de Cardiología Resultados: Respondieron 183 residentes. El 100% dijo haber recibido algún tipo de maltrato. Ser humillado por un error cometido y los gritos, son las formas de maltrato mencionadas con mayor frecuencia; un residente superior, un paciente y/o sus familiares fueron señalados como los responsables de las agresiones recibidas. Casi la mitad de residentes (46%) dijeron haber sido maltratados por el personal de enfermería. El 33,5% reconoció haber incurrido en situaciones de maltrato y que éste estuvo dirigido a otro residente, a un médico de planta y/o un médico de otra especialidad. Discusión: Los resultados son similares a otros estudios ya publicados. Por la seguridad de los pacientes y por la salud de los médicos se recomienda incluir en la formación profesional las estrategias para el afrontamiento del estrés y se considera indispensable promover un cambio cultural dentro de las instituciones académicas y asistenciales orientado a crear espacios de trabajo más democráticos y más saludables.

ABSTRACT Background: Mistreatment is defined as the behavior that makes another person feel hurt, undervalued or incompetent. A certain level of intimidation and humiliation during training was considered necessary to prepare the doctor for a difficult profession. The conditions in which medical residences and professional practice are developed today generate a high prevalence of burnout. Objective: The aim of this study was to investigate the perception that Cardiology residents have on the mistreatment received and if they acknowledge having incurred in any aggravating behavior. Methods: A survey was conducted in residents attending the Biannual Cardiology Course of the Argentine Society of Cardiology. Results: A total of 183 residents responded the survey and all of them (100%) reported some type of mistreatment. Being humiliated for making a mistake and shouted at were the most frequently mentioned forms of mistreatment from a senior resident, a patient or their relatives. Almost half of the residents (46%) said they had been mistreated by the nursing staff. while 33.5% acknowledged having incurred in aggravating situations directed against another resident, a staff doctor and/ or another specialty physician. Discussion: The results are similar to other studies already published. For the safety of patients and the health of physicians, it is recommended to include strategies for coping with stress and it is considered essential to promote cultural changes within academic and care institutions aimed at creating more democratic and healthier working environments.

Residência multiprofissional em saúde: análise da implantação de dois programas pela universidade federal de santa catarina, brasil / Multiprofessional residency in health: analysis of the implementation of two programs by the universidade federal de santa catarina, brazil / Residencia multiprofesional en salud: análisis de la implemen-tación de dos programas por la universidade federal de santa catarina, brasil

Resumo As residências multiprofissionais em saúde atendem às necessidades do Sistema Único de Saúde e da Política de Educação Permanente, sendo instrumento de formação e inserção de profissionais nos serviços de saúde. Por ser uma nova intervenção, propôs-se uma análise para avaliar o grau de implantação do programa em dois pontos de atenção vinculados à Universidade Federal de Santa Catarina, com análises documentais e revisões bibliográficas, com elaboração dos modelos teórico, lógico e da matriz de análise e julgamento. A coleta de dados, realizada de maio a agosto de 2018, foi feita por meio de entrevistas com atores do programa. Os resultados da avaliação apresentaram aspectos favoráveis quanto à organização do projeto político pedagógico, estruturação dos órgãos de acompanhamento previstos na legislação e elaboração do processo seletivo. Como aspectos limitantes, citam-se a ausência de recursos financeiros para implantação das atividades dos residentes, baixa inserção dos tutores e preceptores no processo de aprendizagem, poucas iniciativas de capacitações para os atores, bem como ausência de avaliação pela Comissão Nacional de Residências Multiprofissionais em Saúde.

Abstract The multiprofessional residencies in health meet the needs of the Brazilian Unified Health System and of the Ongoing Education Policy, and are a tool for the training and insertion of professionals in the health services. Due to the fact that it is a new intervention, we proposed an analysis to assess the degree of implementation of the program in two health care services connected to the Universidade Federal de Santa Catarina, with a documentary analysis and bibliographic reviews, with the development of the logical and theoretical models, and of the analysis and assessment matrix. The data collection, which took place between May and August 2018, was made through interviews with 16 actors from the program. The results of the assessment show favorable aspects regarding the organization of the political pedagogical process, the structuring of the follow-up agencies provided in the legislation, and the development of the selection process. As limiting aspects, we can mention the absence of financial resources to implement the activities of the residency students, low insertion of the tutors and preceptors in the learning process, few training initiatives for the actors, as well as absence of an evaluation by the National Committee of Multiprofessional Residencies in Health.

Resumen Las residencias multiprofesionales en salud cumplen las necesidades del Sistema Único de Salud Brasileño y de la Política de Educación Permanente, siendo instrumento de formación e inserción de profesionales en los servicios de salud. Por ser una nueva intervención, se propuso un análisis para evaluar el grado de implementación del programa en dos puntos de atención vinculados a la Universidade Federal de Santa Catarina, con análisis de documentos y revisiones bibliográficas, con elaboración de los modelos teórico, lógico y de la matriz de análisis y evaluación. La obtención de datos, realizada de mayo a agosto de 2018, fue realizada por medio de entrevistas con 16 actores del programa. Los resultados de la evaluación presentaron aspectos favorables en cuanto a la organización del proyecto político pedagógico, estructuración de los órganos de seguimiento previstos en la legislación y elaboración del proceso selectivo. Como aspectos limitantes, se citan la ausencia de recursos financieros para implementación de las actividades de los residentes, baja inserción de los tutores y preceptores en el proceso de aprendizaje, pocas iniciativas de capacitaciones para los actores, así como ausencia de evaluación por la Comisión Nacional de Residencias Multiprofesionales en Salud.

State of the art of integrated, multiprofessional and in professional Health area residencies

The objective of this research was to analyze the state of the art on integrated, multiprofessional and professional Health area residencies through an integrative bibliographical review, from 2006 to 2016, in Portuguese, English and Spanish. 109 articles from Brazil, Canada, USA, Spain and Africa were analyzed. Among the results, it was showed that the main motivation to perform the residency is the need for specialization required by the labor market. The residency experiences in the United States and Canada are in the professional area, having a complementary character to the undergraduation and they emphasize training for research and teaching. In Brazil, the residencies in health represent projects of education through work to overcome limitations of the undergraduation. The purpose of a multiprofessional residency is to train qualified professionals for collaborative interprofessional practice, consistent with the Brazilian National Health System (SUS) guidelines.(AU)

¿Cuál es la relación entre el síndrome de burnout, el sentido de la vida y el proyecto de vida laboral en los médicos residentes?: una perspectiva logoterapéutica / What is the relationship between burnout syndrome, the meaning of life and the project of working life in resident physicians ?: a logotherapeutic perspective

Introducción: el síndrome de burnout (BO) suele afectar a médicos residentes, debido al estrés laboral crónico. Desde un marco logoterapéutico, la pérdida de un sentido de la vida (SV) es el denominador más común de todas las formas de perturbación emocional, y el BO podría enmarcarse dentro de un proyecto de vida laboral (PVL) con enrolamiento enajenante. El objetivo principal del trabajo es evaluar la relación entre el BO, el SV y el PVL, en los programas de residencia del Hospital Italiano de Buenos Aires. Población y métodos: se evaluaron residentes de 6 programas de residencia del Hospital Italiano de Buenos Aires, a través de un cuestionario. El BO se midió con el "Maslach Burnout Inventory" (MBI). El SV se midió con el "Purpose in Life Test" (PIL Test). El PVL se midió con la Escala de PVL de la Dra. Isabel Pérez Jáuregui. Resultados: participaron 104 residentes. El 28,8% de los evaluados mostraron BO, el 18,3% falta de SV y el 30,8% un PVL inauténtico con sobreadaptación. Tanto la falta de SV como el PVL inauténtico con sobreadaptación se asociaron en forma estadísticamente significativa con BO (p < 0,01), y la presencia de cualquiera de estas alteraciones aumentó en casi 18 veces (odds ratio [OR] crudo) la probabilidad de presentar el síndrome. Los OR ajustados de falta de SV (6,28) y PVL inauténtico (9,57) para la presencia de BO continuaron siendo estadísticamente significativos. Por último, en esta investigación pudimos determinar que las subescalas del MBI agotamiento y despersonalización se correlacionaron negativamente con el PIL Test (r=-0,41 y r=-0,53, respectivamente) y la Escala de PVL (r=-0,45 y r=-0,42, respectivamente), mientras que la subescala de realización se correlacionó positivamente en forma significativa con estas dos últimas (r=0,63 y r=0,61, respectivamente). Conclusiones: se encontró una relación estadísticamente significativa entre BO, falta de SV y PVL inauténtico, en la residencia. (AU)

Introduction: The Burnout Syndrome (BO) usually affects medical residents because they are exposed to chronic labour stress. From a logotherapeutic view, the loss of meaning and purpose in life (ML) is the common denominator of all types of emotional distress, and the BO could belong to an altered labour life project (LLP) with overadaptation. The objective of this study was to evaluate the relationship between the BO, the ML, and the LLP, in residency programs at a university hospital. Population and methods: residents from six programs at Hospital Italiano de Buenos Aires were evaluated. The BO was measured with the Maslach Burnout Inventory (MBI). The ML was measured with the Purpose in Life Test (Pil Test). The LLP was measured with the LLP Scale created by Doctor Isabel Pérez Jáuregui. Results: one hundred and four residents participated. Out of the evaluated residentes, 28.8% showed BO. The loss of ML was observed in 18.3%, and an altered LLP with overadaptation affected the 30.8% of the sample. Loss of ML and altered LLP with overadaptation were associated in a statistically significant way with BO (p<0.01), and the presence of any of this alterations increased the odds ratio almost 18 times to suffer BO. The adjusted odds ratio of loss of ML (6.28) and altered LLP (9.57) to suffer BO, were also statistically significant. Finally, a negative correlation was observed between exhaustion and despersonalization (MBI) and the Pil Test (r=-0.41 and r=-0.53, respectively) and the LLP Scale (r=-0.45 and r=-0.42, respectively), while a positive significant correlation was observed between the personal accomplishment (MBI) and the Pil Test and LLP Scale (r=0.63 and r=0.61, respectively). Conclusions: in the residency, we found a statistically significant relationship between BO, loss of ML and altered LLP. (AU)

Exposición a la violencia durante la formación profesional de los residentes médicos / Exposure to violence during the vocational training of resident physicians

Resumen Las residencias médicas garantizan la formación y preparación de los futuros especialistas, no solo académica, sino también humana. Sin embargo, existe evidencia de maltrato, discriminación y abusos en los residentes médicos. El objetivo de este trabajo fue identificar experiencias de violencia física, psicológica o sexual de los residentes médicos del estado de Veracruz, México. Se realizó un estudio transversal descriptivo, mediante una metodología cuantitativa, de una población conformada por 656 médicos residentes de 16 unidades receptoras durante el año 2014. El 87 % reportó por lo menos una experiencia de agresión en su tiempo de formación como especialistas y hasta el 50.46 % refirió violencia psicológica. Sus principales agresores fueron jefes de servicio (33.5 %) y compañeros residentes (33.5 %), viéndose más afectados en el turno matutino (34.76 %). De la población total, 51.52 % son hombres y 48.48 % mujeres. En relación al análisis bivariado se obtuvieron los siguientes resultados: correlación entre sexo y violencia psicológica: X 2 = 9.740 6, p = 0.004; violencia fisica: X 2 = 4.876 4, p = 0.003; y violencia sexual: X 2 = 4.868 4, P = 0.001. Los varones presentaron tasas de agresión más altas en el grupo de médicos residentes sometidos a mayor nivel de violencia psicológica, física y sexual. Con este estudio se enfatiza la importancia de forjar valores institucionales en la práctica médica, como el respeto y la dignidad, entre los médicos residentes, superiores y/o profesionales que intervienen en la formación y perfeccionamiento de sus especialidades.

Abstract The Medical residencies guarantee the academic and human apprenticeship and training of the future medical specialists. Nevertheless, there is evidence of maltreatment, discrimination and abuse against the medical residents. The purpose of this work was to identify experiences of physical, psychological or sexual violence of medical residents in the state of Veracruz, Mexico. A cross-sectional quantitative analysis was carried out focusing on a population of 656 residents from 16 receiving medical centers during 2014. Results indicate that 87% reported at least one experience of physical violence during their medical internship as specialists. Additionally, and up to 50.46% it reported psychological violence. The main aggressors were reported to be chiefs of service (33T5 %) and resident partners (33.5 %) and participants were more affected during the morning shift (34.76 %). 51.52 % of the participating population are males and 48.48 % are fema les. As regards The bivariate analysis revealed the following results: correlation between gender and psychological violence: X2 = 9.740 6, p = 0.004; physical violence: X2 = 4.876 4, p = 0.003; and sexual violence: X2 = 4.868 4, p = 0.001. Males reported higher aggression rates in their medical internships since they were subject to higher levels of psychological, physical and sexual violence. The results of the study emphasize the importance of forging institutional values as an integral part of medical residency programs. Respect and the dignity among medical residents, superiors and health professionals who are involved in training and apprenticeships of specialists should be promoted.

Práticas exitosas dos preceptores de uma residência multiprofissional: interface com a interprofissionalidade / Preceptor's best practices in a multiprofessional residency: interface with interprofessionality

Resumo Nosso artigo, fundamentado na Pesquisa Apreciativa, apresenta e discute as melhores práticas de um grupo de preceptores de um programa de residência multiprofissional em Saúde. As melhores práticas identificadas são: a consulta multiprofissional, o acolhimento dos residentes e as ações integradas entre as diferentes ênfases da residência. Além dessas, identificaram-se as estratégias para desenvolver as práticas nos cenários de saúde que seguem os pressupostos da educação interprofissional, já que promovem a reflexão de diferentes atores do processo na construção de práticas que buscam maior atenção à saúde dos usuários do Sistema Único de Saúde (SUS).(AU)

Resumen Nuestro artículo, fundamentado en la investigación apreciativa, presenta y discute las mejores prácticas de un grupo de preceptores de un Programa de Residencia Multiprofesional en Salud. las mejores prácticas identificadas son: la consulta multiprofesional, la acogida de los residentes y las acciones integradas entre los diferentes énfasis de la residencia. Además de esas, se identificaron las estrategias para desarrollar las prácticas en los escenarios de Salud que siguen los supuestos de la educación interprofesional, puesto que promueven la reflexión de diferentes actores del proceso en la construcción de prácticas que buscan una mejor atención de la salud de los usuarios del Sistema Brasileño de Salud (SUS).(AU)

ABSTRACT In this article, based on Appreciative Inquiry, we present and discuss the best practices of a group of preceptors from a multiprofessional health residency program in Brazil. The best practices we identified are the multiprofessional consultation, the reception given to residents, and the integrated actions among different majors of the residency. In addition, we identified their strategies to develop the practices in health settings. The practices follow the presuppositions of interprofessional education, as they promote the reflection of different actors on the construction of practices that aim at the provision of better healthcare for users of the Brazilian National Health System (SUS).(AU)

A criação de sítio para disseminar informações sobre medicamentos no SUS: um relato de experiência / Creating site to disseminate information about medicines in the SUS: an experience report / Creación de sitio para difundir información acerca de los medicamentosen el SUS: un relato de experiencia

Neste estudo é relatado o processo de desenvolvimento de sítio sobre medicamentos no SUS. Para a escolha dos temas a serem inseridos no sítio, primeiramente foram elencadas as dificuldades de entendimento quanto a Assistência Farmacêutica apresentada pelos profissionais de saúde e usuários do SUS. Em seguida, estes problemas foram discutidos com farmacêuticos especialistas para delimitação dos tópicos e conteúdo para criação das páginas no sítio. Os tópicos incluídos estão divididos em 2 grandes temas: informações sobre a Assistência Farmacêutica no SUS e orientações para a promoção do uso racional de medicamentos. O processo de desenvolvimento do sítio pode servir como exemplo para outros programas de residência, contribuindo para realização de trabalhos de conclusão de residência que disseminem informações relevantes para o usuário do SUS (profissional de saúde ou paciente) na internet e favoreçam a integração entre serviço, ensino, pesquisa e comunidade.

The aim of this study was to report the process of a website creation that disseminates information on SUSdrugs. First, topics for the website were selected based on problems in understanding the Pharmaceutical Service presented by healthcare providers and patients. Then these problems were discussed with pharmaceutical specialists to determine the topics and content to be included on the website. The topics were divided into two mains themes: information on the Pharmaceutical Service in SUS, and guidelines to promote the rational use of medicines. The website development report may serve as an example for other residency programs, and may contribute to the development of other residency theses that disseminate relevant information to patients and healthcare providers, promoting the integration of service, teaching,research and community.

El objetivo de este estudio fue describir el proceso de creación de un sitio web que difunde información sobre las drogas SUS. En primer lugar, fueron seleccionados los temas para el sitio basado en problemas en la comprensión del Servicios Farmacéuticos presentado por los profesionales sanitarios y los pacientes. Entonces estos problemas se discutieron con especialistas farmacéuticos para delimitación de los temas y el contenido para crear las páginas en el sitio. Los temas fueron divididos en dos principales temas: información sobre el Servicios Farmacéuticos en el SUS, y directrices para promover el uso racional de los medicamentos. El proceso de desarrollo del sitio puede servir de ejemplo para otros programas de residencia, y puede contribuir al desarrollo de otras tesis de residencia que difunden información relevante para los pacientes y los profesionales de la salud, la promoción de la integración de los servicios, la enseñanza, la investigación y la comunidad.

Correlación entre el clima educacional y el síndrome de desgaste profesional en los programas de residencia de un hospital universitario / Correlation between the educational environment and burn-out syndrome in residency programs at a university hospital

Introducción. El clima educacional (CE) se relaciona con los logros y la satisfacción. Se ha comunicado una alta prevalencia del síndrome de desgaste profesional (BO) en la residencia. El objetivo de este trabajo fue evaluar la correlación entre el CE y la presencia de BO en los programas de residencia de un hospital universitario. Población y métodos. Se evaluaron residentes de cinco programas del Hospital Italiano de Buenos Aires. Se registró: especialidad, año de residencia, sexo, nacionalidad y convivencia. El CE se midió con el Postgraduate Hospital Education Environment Measure, PHEEM, que evalúa autonomía, soporte y enseñanza. El BO se midió con el Maslach Burnout Inventory (MBI) que evalúa agotamiento, despersonalización y realización personal. Resultados. Participaron 92 residentes. La media de CE total fue de 106,8 (clima más positivo que negativo). El 19,6% de los evaluados mostraron BO. Hubo diferencias significativas de CE entre las poblaciones con y sin BO; medias: 98,7 contra 108,8 (p= 0,0056). Se observó una correlación significativa negativa entre CE/agotamiento (r= -0,24) y CE/ despersonalización (r= -0,35) y una correlación significativa positiva entre CE y realización (r= 0,44). Mayor correlación en igual sentido se observó entre la subescala de autonomía del PHEEM y el BO (r= -0,58; -0,41 y 0,46, respectivamente). Conclusiones. Se encontró una correlación significativa entre el CE y el BO (inversa con agotamiento y despersonalización, y directa con realización) en la residencia. Esta correlación fue de mayor fuerza e igual sentido con los ítems que evaluaron autonomía.

Introduction. The educational environment (EE) is related to satisfaction and achievement. A high prevalence of professional burnout (BO) syndrome has been reported in the residency. The objective of this study was to evaluate the correlation between EE and the presence of burnout in residency programs at a university hospital. Population and methods. Residents from fve programs at Hospital Italiano de Buenos Aires were evaluated. The following items were recorded: specialty, year of residency, sex, nationality and coexistence. The Postgraduate Hospital Education Environment Measure (PHEEM) that evaluates autonomy, teaching and social support, was used to measure EE. Burnout was measured with the Maslach Burnout Inventory (MBI) that evaluates exhaustion, depersonalization, and personal accomplishment. Results. Ninety two residents participated. The mean EE was 106.8 (more positive than negative environment). Out of the evaluated residents, 19.6% showed burnout. There were signifcant differences in the EE between the populations with and without burnout; mean values: 98.7 vs. 108.8 (p= 0.0056). A negative signifcant correlation was observed between EE and exhaustion (r= -0.24) and EE and depersonalization (r= -0.35) and a positive signifcant correlation was found between EE and personal accomplishment (r= 0.44). In the same sense, a greater correlation was observed between burnout and PHEEM autonomy subscale (r= -0.58; -0.41 and 0.46, respectively). Conclusions. In the residency, a significant correlation was found between the EE and burnout (reverse with exhaustion and depersonalization, and direct with personal accomplishment). This correlation had greater strength and the same sense for items evaluating autonomy.

Emergency Residents' Current Status and Preferences for Shift Work During Extra-regular Working Time in Korea

BACKGROUND: The workload of emergency medicine residents (EMRs) is expected to be high. Especially, and working during extra-regular working time (ERT) provides them with great stress. In spite of this, their workload and preference for shift work during ERT has not been studied in Korea. METHOD: The postal survey was sent to the EMRs of training hospitals. The survey consisted of 10 questions which assessed their shift lengths, shift-length preferences, degree of fatigue after night shift, allowance for an ERT shift and so on. The analysis was done using the SPSS Win program. RESULT: Surveys were sent to 240 EMRs and eighty-two (82) EMRs responded. Most of them (85.4%) had more than 10 night shifts per month. The most common shift lengths were 12 hours (53.7%) and 24 hours (23.2%), and the most preferred shift length was 12 hours (50.0%). More than half of the EMRs felt very tired after night shifts. The desired allowance for an ERT night shift was 2.1 times on Saturday, 2.5 times on Sunday, and 3.6 times on holiday, compared to that for a weekday night shift. CONCLUSION: The current workload of an EMR is very high. The desire from ERT shift is low, so appropriate strategies should be sought to compensate the ERT workload.