Factors Associated With Resident Satisfaction With Their Continuity Experience

Serwint, Janet R.; Feigelman, Susan; Dumont-Driscoll, Marilyn; Collins, Rebecca; Zhan, Min; Kittredge, Diane; for the CORNET Investigators,

doi:10.1367/1539-4409(2004)004<0004:FAWRSW>2.0.CO;2

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Volume 4, Issue 1 , Pages 4-10, January 2004

Factors Associated With Resident Satisfaction With Their Continuity Experience

Janet R. Serwint, MD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
- Address correspondence to Janet R. Serwint, MD, Division of General Pediatrics, Johns Hopkins Hospital, Park 389, 600 N Wolfe St, Baltimore, MD 21287
Susan Feigelman, MD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
Marilyn Dumont-Driscoll, MD, PhD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
Rebecca Collins, MD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
Min Zhan, PhD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
Diane Kittredge, MD
- From the Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Md. CORNET, the Continuity Research Network of the Ambulatory Pediatric Association
for the CORNET Investigators

Received 2 June 2003; accepted 9 October 2003.

Objective.—To identify factors associated with resident satisfaction concerning residents' continuity experience.

Design and Methods.—Continuity directors distributed questionnaires to residents at their respective institutions. Resident satisfaction was defined as satisfied or very satisfied on a Likert scale. The independent variables included 60 characteristics of the continuity experience from 7 domains: 1) patient attributes, 2) continuity and longitudinal issues, 3) responsibility as primary care provider, 4) preceptor characteristics, 5) educational opportunities, 6) exposure to practice management, and 7) interaction with other clinic and practice staff. A stepwise logistic regression model and the Generalized Estimating Equations approach were used.

Results.—Thirty-six programs participated. Of 1155 residents (71%) who provided complete data, 67% (n = 775) stated satisfaction with their continuity experience. The following characteristics (adjusted odds ratio [OR] and 95% confidence interval [CI]) were found to be most significant: preceptor as good role model, OR = 7.28 (CI = 4.2, 12.5); appropriate amount of teaching, OR = 3.25 (CI = 2.1, 5.1); involvement during hospitalization, OR = 2.61 (CI = 1.3, 5.2); exposure to practice management, OR = 2.39 (CI = 1.5, 3.8); good balance of general pediatric patients, OR = 2.34 (CI = 1.5, 3.6); resident as patient advocate, OR = 1.74 (CI = 1.2, 2.4); and appropriate amount of nursing support, OR = 1.65 (CI = 1.1, 2.6). Future career choice, type of continuity site, and level of training were not found to be statistically significant.

Conclusions.—Pediatric resident satisfaction was significantly associated with 7 variables, the most important of which were the ability of the preceptor to serve as a role model and teacher. The type of continuity site was not significant. Residency programs may use these data to develop interventions to enhance resident satisfaction, which may lead to enhanced work performance and patient satisfaction.

KEY WORDS: continuity experience , CORNET research network , medical education , preceptor as role model , Residency Review Committee requirements , resident satisfaction