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首页> 外文期刊>American journal of bioethics >The Importance of Fostering Ownership During Medical Training
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The Importance of Fostering Ownership During Medical Training

机译：医学培训中培养主人翁意识的重要性

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摘要

There is a need to consider the impact of the new resident-hours regulations on the variety of aspects of medical education and patient care. Most existing literature about this subject has focused on the role of fatigue in resident performance, education, and health care delivery. However, there are other possible consequences of these new regulations, including a negative impact on decision ownership. Our main assumption of is that increased shift work in medicine can decrease ownership of treatment decisions and impact negatively on quality of care. We review some potential components of decision ownership in treatment context and suggest possible ways in which the absence of decision ownership may decrease the quality of medical decision making. The article opens with the definition of decision ownership and the overview of some contextual factors that may contribute to the development of ownership in medical residency. The following section discusses decision ownership in medical care from the perspective of "diffusionof responsibility." We question the quality of choices made within narrow decisional frames. We also compare isolated and interrelated choices, assuming that residents make more isolated decisions during their shifts. Lastly, we discuss the consequences of decreased decision ownership impacting the delivery of health care.
机译：有必要考虑新的居民时间条例对医学教育和患者护理各个方面的影响。关于该主题的大多数现有文献都集中于疲劳在居民表现，教育和医疗保健中的作用。但是，这些新法规还可能带来其他后果，包括对决策所有权的负面影响。我们的主要假设是，更多的轮班工作可能会减少治疗决策的所有权，并对护理质量产生负面影响。我们回顾了治疗背景下决策所有权的一些潜在组成部分，并提出了缺乏决策所有权可能会降低医疗决策质量的可能方法。本文首先介绍了决策所有权的定义，并概述了可能有助于医疗居住权发展的一些背景因素。下一节从“责任扩散”的角度讨论医疗决策的所有权。我们质疑在狭窄的决策框架内做出的选择的质量。我们还比较了孤立的和相互关联的选择，假设居民在轮班期间做出了更多孤立的决定。最后，我们讨论了决策所有权下降对医疗服务交付的影响。

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