title: Factors associated with resident satisfaction with their continuity experience.
abstract: OBJECTIVE
  To identify factors associated with resident satisfaction concerning residents' continuity experience.
  
  
  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.
authors.affiliation: Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD 21287, USA. jserwint@jhmi.edu
authors.forename: Janet R
authors.initials: JR
authors.lastname: Serwint
authors.forename: Susan
authors.initials: S
authors.lastname: Feigelman
authors.forename: Marilyn
authors.initials: M
authors.lastname: Dumont-Driscoll
authors.forename: Rebecca
authors.initials: R
authors.lastname: Collins
authors.forename: Min
authors.initials: M
authors.lastname: Zhan
authors.forename: Diane
authors.initials: D
authors.lastname: Kittredge
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007588:Job Satisfaction; D010372:Pediatrics / Q000193:education*; D011231:Preceptorship; D014481:United States