實習醫師留任住院醫師之因素探討－－以臺南與高雄縣市醫院為例

A Pilot Study on the Determinants of Interns’ Retention - Evidence from hospitals in Tainan and Kaohsiung Areas

實習醫師是醫院專業服務人力重要來源，為穩定維持醫院人力資源，有必要瞭解實習醫師留任住院醫師之因素，作為醫院人力投資的依據。研究目的：探討與了解住院醫師之個人特質與在實習階段之工作價值觀、工作滿意度、組織承諾與留任之間的相關性，以及工作價值觀、工作滿意度與組織承諾等三個變項是否可以有效地預測實習醫師留任在實習醫院擔任住院醫師。研究方法：使用結構性問卷調查方式，以現場或郵寄方式發放問卷，採非隨機抽樣之立意抽樣，研究對象為台南縣市與高雄縣市之區域教學（含）以上醫院之所有職級的住院醫師。總計發出問卷230份，有效問卷共計218份，有效問卷回收率為90.57%。問卷結果以SPSS13.0軟體進行描述性統計、變異數、相關與邏輯式迴歸統計分析。研究結果：工作滿意度之「主管決策能力」對留任具有差異性。而經由邏輯式迴歸分析發現，實習期間之工作滿意度對是否留任的決策與行為具有預測力。工作滿意度是實習醫師決定未來選擇住院醫師佔重要因素之一，並且可以有效地預測實習醫師是否願意留在實習醫院擔任住院醫師。結論：若欲留住實習醫師於醫院內任職住院醫師，必須提高工作滿意度、提供適當的行政管理自主性與加強外在獎酬因子。

Physician is a highly professional occupation. The intensity of workplaces and the job specialization make the physicians relocate their jobs easily. This might be good for physician him/herself, however, it might decrease the loyalty and further cause problems for hospitals. The purpose of this study is to investigate and discuss the relationship of personality, work value, work satisfaction, and organizational commitment for resident doctors during their practicum and retention. In addition, which variables (work value, work satisfaction and organizational commitment) would predict retention effectively would be observed. The survey was conducted by non-random sampling with structured questionnaires. A total of 230 resident doctors practiced in 9 hospitals accredited as district teaching hospitals or higher was included for analysis. The response rate of the overall questionnaires was 90.57%. SPSS 13.0 was used to examine the descriptive statistics, variance, correlation, and logistic regression. Of all research variables, which were noted significant difference between physician’s work value, work satisfaction and retention, it was included chief decision. Logistic regression revealed the resident’s work satisfaction and organizational commitment were positively related to retention. The result of this study indicated that work satisfaction was an important factor for intern to decide which specialization they would take. Furthermore, they could predict if they would retain in practical hospital. This implied that hospitals have to increase their work satisfaction and provide them adequate management authority if they intended to keep their intern doctors. Besides, to improve extrinsic promotional and reward could keep more doctors.