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To enhance patient care ownership: A baseline cross-sectional study on pediatric training
Hiro Nakao1,2, Osamu Nomura1,3, Mitsuru Kubota2
1Center for Postgraduate Education and Training, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
Insights
Physician trainees
Area of Science:
- Medical Education
- Pediatrics
- Physician Training
Background:
- Patient care ownership (PCO) is a growing concern in global physician training.
- Limited data exists on PCO within Japanese pediatric residency programs.
- Previous work at NCCHD showed improved well-being with work style reforms.
Purpose of the Study:
- To establish a baseline for PCO among pediatric trainees at the National Center for Child Health and Development (NCCHD).
- To investigate the correlations between PCO, mental well-being, and work conditions in this cohort.
Main Methods:
- Cross-sectional surveys were administered to pediatric trainees (n=15 nearing completion, n=34 ongoing).
- Data collected included demographics, work conditions, depression (CES-D), burnout (MBI), and the Japanese Patient Care Ownership Scale (J-PCOS).
Main Results:
- Response rates were 100% and 81% for the respective surveys.
- Mean J-PCOS scores were 5.4 and 5.3.
- J-PCOS scores significantly correlated with adherence to daytime rest before night shifts (β, 0.6-0.7) and personal accomplishment from MBI (r=-0.34, β=-0.1).
Conclusions:
- Shiftwork, mental well-being, and PCO appear positively interconnected.
- Enhancing a sense of accomplishment or meaning in work may improve PCO and trainee well-being.
Background:
Patient care ownership (PCO) has become of great concern in worldwide physician training and the National Center for Child Health and Development (NCCHD) in Japan. There are only a few reports on PCO in Japan. We previously reported work time reduction and mental improvements in relation to implementing shiftwork and work style reform at the NCCHD. This study aimed to measure the baseline of PCO and explore the relationships between PCO and mental well-being and work conditions in pediatric training at the NCCHD.
Methods:
We conducted questionnaire-based cross-sectional surveys of 15 pediatric trainees soon to complete their training in March 2024 and 42 ongoing pediatric trainees in September 2024. Data were obtained regarding demographics, work conditions, the Center for Epidemiologic Studies Depression Scale (CES-D), Maslach Burnout Inventory (MBI), and the Japanese version of the Patient Care Ownership Scale (J-PCOS).
Results:
The response rate for each survey was 100% (15/15) in March 2024 and 81% (34/42) in September 2024. The mean J-PCOS scores were 5.4 in the former and 5.3 in the latter survey. The combined analyses of these data indicated that J-PCOS was significantly associated with compliance with daytime off before nightwork (β, 0.6-0.7) and the personal accomplishment subscale of MBI (correlation coefficient, -0.34; β, -0.1).
Conclusions:
Shiftwork, mental well-being, and PCO might be positively related to one another. A feeling of accomplishment, or a sense of meaning in work, can be a target of intervention to enhance PCO while promoting trainees' well-being.
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