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https://www.readbyqxmd.com/read/27923090/association-between-end-of-rotation-resident-transition-in-care-and-mortality-among-hospitalized-patients
#1
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
#2
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 not difference in patient outcomes or resident wellbeing 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 (PDs), surgical residents and attending surgeons who participated in the FIRST Trial...
November 8, 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
#3
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
#4
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 to current Accreditation Council for Graduate Medical Education (ACGME) duty hour policy (Standard Policy). STUDY DESIGN: We obtained examination scores on the American Board of Surgery (ABS) In-Training Examination (ABSITE), Qualifying Examination (QE, written boards), and Certifying Examination (CE, 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 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27873408/number-needed-to-eat-pizza-and-resident-conference-attendance
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
September 30, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27550326/students-educational-experiences-and-interaction-with-residents-on-night-shifts
#12
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
#13
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
#14
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
#15
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...
2016: BMC Medical Education
https://www.readbyqxmd.com/read/27234632/program-director-perceptions-of-surgical-resident-training-and-patient-care-under-flexible-duty-hour-requirements
#16
Lily V Saadat, Allison R Dahlke, Ravi Rajaram, Lindsey Kreutzer, Remi Love, David D Odell, Karl Y Bilimoria, Anthony D Yang
BACKGROUND: The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27103047/patient-outcomes-when-housestaff-exceed-80-hours-per-week
#17
David Ouyang, Jonathan H Chen, Gomathi Krishnan, Jason Hom, Ronald Witteles, Jeffrey Chi
BACKGROUND: It has been posited that high workload and long work hours for trainees could affect the quality and efficiency of patient care. Duty hour restrictions seek to balance patient care and resident education by limiting resident work hours. Through a retrospective cohort study, we investigated whether patient care on an inpatient general medicine service at a large academic medical center is impacted when housestaff work more than 80 hours per week. METHODS: We identified all admissions to a housestaff-run general medicine service between June 25, 2013 and June 29, 2014...
September 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27073829/twelve-tips-for-improving-the-general-surgery-resident-night-float-experience
#18
Rebecca M Rentea, Jared A Forrester, Nathan W Kugler, Anahita Dua, Travis P Webb
Restriction of resident duty hours has resulted in the implementation of night float systems in surgical and medical programs. Many papers have examined the benefits and structure of night float, but few have addressed patient safety issues, quality patient care, and the impact on the residency education system. The objective of this review is to provide practical tips to optimize the night float experience for resident training while continuing to emphasize patient care. The tips provided are based on the experiences and reflections of residents, supervising staff, group discussions, and the available literature in a hospital-based general surgery residency program...
June 2015: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/27068844/operative-variability-among-residents-has-increased-since-implementation-of-the-80-hour-workweek
#19
Ralph C Quillin, Alexander R Cortez, Timothy A Pritts, Dennis J Hanseman, Michael J Edwards, Bradley R Davis
BACKGROUND: The ACGME instituted duty hour restrictions in 2003. This presents a challenge for surgical residents who must acquire a medical and technical knowledge base during their training. Although the effect of work hour limitations on operative volume has been examined, no study has examined whether duty hour reform has had an effect on operative volume variability. STUDY DESIGN: The ACGME operative log data of graduating general surgery residents from 1992 to 2015 were examined...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27044399/curriculum-reform-for-residency-training-competence-change-and-opportunities-for-leadership
#20
Amy B Fraser, Emma J Stodel, Alan J Chaput
PURPOSE: Certain pressures stemming from within the medical community and from society in general, such as the need for increased accountability in resident training and restricted resident duty hours, have prompted a re-examination of methods for training physicians. Leaders in medical education in North America and around the world champion competency-based medical education (CBME) as a solution. The Department of Anesthesiology at the University of Ottawa launched Canada's first CBME program for anesthesiology residents on July 1, 2015...
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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