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https://www.readbyqxmd.com/read/28000231/duty-hour-restrictions-and-surgical-complications-for-head-and-neck-key-indicator-procedures
#1
Aaron Smith, Nikhita Jain, Jim Wan, Lei Wang, Merry Sebelik
OBJECTIVES/HYPOTHESIS: Graduate medical education has traditionally required long work hours, allowing trainees little time for adequate rest. Based on concerns over performance deterioration with sleep deprivation and its effect on patient outcomes, duty hour restrictions have been mandated. We sought to characterize complications from otolaryngology key indicator procedures performed before and after duty hour reform. STUDY DESIGN: Retrospective cross-sectional analysis of National Inpatient Sample (NIS)...
December 21, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27973648/complementing-operating-room-teaching-with-video-based-coaching
#2
Yue-Yung Hu, Laura M Mazer, Steven J Yule, Alexander F Arriaga, Caprice C Greenberg, Stuart R Lipsitz, Atul A Gawande, Douglas S Smink
Importance: Surgical expertise demands technical and nontechnical skills. Traditionally, surgical trainees acquired these skills in the operating room; however, operative time for residents has decreased with duty hour restrictions. As in other professions, video analysis may help maximize the learning experience. Objective: To develop and evaluate a postoperative video-based coaching intervention for residents. Design, Setting, and Participants: In this mixed methods analysis, 10 senior (postgraduate year 4 and 5) residents were videorecorded operating with an attending surgeon at an academic tertiary care hospital...
December 14, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27969561/development-of-a-night-float-call-model-for-obstetrics-and-gynaecology-residency-the-process-and-residents-perceptions
#3
Lynn Sterling, Carmen McCaffrey, Michael Secter, Rebecca Rich, Jessica Green, Lindsay Shirreff, Donna Steele
The 2013 pan-Canadian consensus Report on Resident Duty Hours identified that traditional 24-hour duty periods pose risks to the well-being of residents and should be avoided. In anticipation of duty-hour restrictions, the Obstetrics and Gynaecology Residency Program at the University of Toronto developed and implemented a night float (NF) call model over a three-year span. Quarterly resident surveys have consistently shown that the NF system is preferred to traditional 24-hour call and has resulted in reduced fatigue and improved continuity of patient care...
November 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27965068/pda-based-self-work-sampling-study-of-pediatric-interns-quantifies-workday-and-educational-value
#4
Joyce K Campbell, Michael V Ortiz, Mary C Ottolini, Sarah Birch, Dewesh Agrawal
OBJECTIVE: Optimizing clinical proficiency and education of residents has become more important with restricted residency duty hours. Our objective was to investigate how interns spend their time on inpatient rotations and the perceived educational value of workday activities. METHODS: A descriptive, self-work sampling study using a personal digital assistant (PDA) to randomly query interns on inpatient rotations in real time as to their activity and the perceived educational value of that activity on a 4-point Likert scale...
December 10, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27938726/-the-remains-of-the-day-a-working-day-in-a-university-children-s-hospital
#5
Florian Heinen, Mirjam N Landgraf, Jens Böhmer, Ingo Borggräfe, Christoph Bidlingmaier, Katrin Krohn, Florian Hoffmann, Thomas Nicolai, Matthias Weigl, Rüdiger von Kries, Lucia Albers
BACKGROUND: Limited time available for direct patient contact and a lot of time required for administrative duties have been reported by physicians working in adult medicine. OBJECTIVE: To characterize the typical daily work routine in a major pediatric university hospital. MATERIALS AND METHODS: A self-administered questionnaire was completed by physicians in the University Children's Hospital, Munich. The questionnaire captured the time spent on direct patient contact and on administrative tasks as well as the physicians' clinical experience and the location where the respective work was actually carried out (inpatient ward, outpatient emergency department, specialized outpatient clinic or department for developmental medicine)...
November 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27923090/association-between-end-of-rotation-resident-transition-in-care-and-mortality-among-hospitalized-patients
#6
Joshua L Denson, Ashley Jensen, Harry S Saag, Binhuan Wang, Yixin Fang, Leora I Horwitz, Laura Evans, Scott E Sherman
Importance: Shift-to-shift transitions in care among house staff are associated with adverse events. However, the association between end-of-rotation transition (in which care of the patient is transferred) and adverse events is uncertain. Objective: To examine the association of end-of-rotation house staff transitions with mortality among hospitalized patients. Design, Setting, and Participants: Retrospective multicenter cohort study of patients admitted to internal medicine services (N = 230 701) at 10 university-affiliated US Veterans Health Administration hospitals (2008-2014)...
December 6, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27884806/exploring-qualitative-perspectives-on-surgical-resident-training-well-being-and-patient-care
#7
Lindsey Kreutzer, Allison R Dahlke, Remi Love, Kristen A Ban, Anthony D Yang, Karl Y Bilimoria, Julie K Johnson
BACKGROUND: The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial found no difference in patient outcomes or resident well-being between more restrictive and flexible duty hour policies. Qualitative methods are appropriate for better understanding the experience and perceptions of those affected by duty hour regulations. We conducted a pilot qualitative study on how resident duty hour regulations are perceived by general surgery program directors, surgical residents, and attending surgeons who participated in the FIRST Trial...
November 21, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884803/association-between-resident-perceptions-of-patient-safety-and-duty-hour-violations
#8
Richard S Matulewicz, David D Odell, Jeanette W Chung, Kristen A Ban, Anthony D Yang, Karl Y Bilimoria
BACKGROUND: Residents are often required to balance whether to adhere to duty hour policies or violate them to care for patients and obtain educational experiences. Little is known about why residents violate duty hour policies and whether there is a relationship between how often residents violate duty hours and concerns about patient safety. Our objective was to assess the association between resident duty hour violations and resident concerns about patient safety. STUDY DESIGN: We analyzed survey data collected from surgery residents who completed the 2015 ABSITE, excluding those in the Flexible Policy arm of the FIRST Trial...
November 11, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884802/association-between-flexible-duty-hour-policies-and-general-surgery-resident-examination-performance-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#9
Eddie Blay, D Brock Hewitt, Jeanette W Chung, Thomas Biester, James F Fiore, Allison R Dahlke, Christopher M Quinn, Frank R Lewis, Karl Y Bilimoria
BACKGROUND: Concerns persist about the effect of current duty hour reforms on resident educational outcomes. We investigated whether a flexible, less-restrictive duty hour policy (flexible policy) was associated with differential general surgery examination performance compared with current ACGME duty hour policy (standard policy). STUDY DESIGN: We obtained examination scores on the American Board of Surgery In-Training Examination, Qualifying Examination (written boards), and Certifying Examination (oral boards) for residents in 117 general surgery residency programs that participated in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial...
November 21, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27873408/number-needed-to-eat-pizza-and-resident-conference-attendance
#10
Michael J Cosimini, Liza Mackintosh, Todd P Chang
The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education...
December 2016: Medical Education
https://www.readbyqxmd.com/read/27803179/physicians-attentional-performance-following-a-24-hour-observation-period-do-we-need-to-regulate-sleep-prior-to-work
#11
P Smyth, K Maximova, J D Jirsch
BACKGROUND: The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. METHODS: We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta...
November 1, 2016: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27788923/evaluating-handoffs-in-the-context-of-a-communication-framework
#12
Hani Hasan, Fadwa Ali, Paul Barker, Robert Treat, Jacob Peschman, Matthew Mohorek, Philip Redlich, Travis Webb
BACKGROUND: The implementation of mandated restrictions in resident duty hours has led to increased handoffs for patient care and thus more opportunities for errors during transitions of care. Much of the current handoff literature is empiric, with experts recommending the study of handoffs within an established framework. METHODS: A prospective, single-institution study was conducted evaluating the process of handoffs for the care of surgical patients in the context of a published communication framework...
October 24, 2016: Surgery
https://www.readbyqxmd.com/read/27779504/scholarly-conversations-in-medical-education
#13
Bridget C O'Brien, Win May, Tanya Horsley
This supplement includes the eight research papers accepted by the 2016 Research in Medical Education Program Planning Committee. In this Commentary, the authors use "conversations in medical education" as a guiding metaphor to explore what these papers contribute to the current scholarly discourse in medical education. They organize their discussion around two domains: the topic of study and the methodological approach. The authors map the eight research papers to six "hot topics" in medical education: (1) curriculum reform, (2) duty hours restriction, (3) learner well-being, (4) innovations in teaching and assessment, (5) self-regulated learning, and (6) learning environment, and to three purposes commonly served by medical education research: (1) description, (2) justification, and (3) clarification...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27777670/association-of-resident-duty-hour-restrictions-on-mortality-of-nervous-system-disease-and-disorder
#14
Ian Churnin, Joel Michalek, Ali Seifi
BACKGROUND : The impact of the 2003 residency duty hour reform on patient care remains a debated issue. OBJECTIVE : Determine the association between duty hour limits and mortality in patients with nervous system pathology. METHODS : Via a retrospective cohort study using the Nationwide Inpatient Sample from 2000-2010, the authors evaluated in-hospital mortality status in those with a primary discharge level diagnosis of disease or disorder of the nervous system...
October 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27762159/experience-of-plastic-surgery-registrars-in-a-european-working-time-directive-compliant-rota
#15
Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27697404/comparison-of-canadian-and-swiss-surgical-training-curricula-moving-on-toward-competency-based-surgical-education
#16
Henry Hoffmann, Daniel Oertli, Robert Mechera, Salome Dell-Kuster, Rachel Rosenthal, Richard Reznick, Hugh MacDonald
OBJECTIVE: Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming. DESIGN: This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR...
January 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/27550326/students-educational-experiences-and-interaction-with-residents-on-night-shifts
#17
Jocelyn Schiller, Max Sokoloff, Chosang Tendhar, John Schmidt, Jennifer Christner
BACKGROUND: The purpose of this mixed-methods study was to investigate whether increased night shifts for students on paediatric rotations had any negative impact on their overall quality of educational experiences in light of the implementation of duty-hour restrictions. METHODS: Both quantitative and qualitative data were collected from 30 students on paediatric rotations during the academic year 2011/12. Students completed two questionnaires, one in response to their experiences during the day shifts and another in response to their experiences during the night shifts...
August 23, 2016: Clinical Teacher
https://www.readbyqxmd.com/read/27521885/surgical-simulation-and-competency
#18
REVIEW
Shunaha Kim-Fine, Erin A Brennand
Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy...
September 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27471928/to-leave-or-to-lie-duty-hour-restrictions-and-patient-ownership
#19
Ryan M Antiel, Thane A Blinman
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/27411835/resident-duty-hour-modification-affects-perceptions-in-medical-education-general-wellness-and-ability-to-provide-patient-care
#20
Andrew Moeller, Jordan Webber, Ian Epstein
BACKGROUND: Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains...
July 13, 2016: BMC Medical Education
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