A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

Nevin, Christa R.; Cherrington, Andrea; Roy, Brita; Daly, David D.; Rodríguez, Jorge Martin; Patel, Mukesh; Snyder, Erin D.; Gaffo, Angelo L.; Barney, Joseph B.; Willig, James H.

doi:10.1186/1472-6920-14-84

Cited by 11 publications

(5 citation statements)

References 19 publications

(13 reference statements)

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“…On the other hand, Nevin et al found that the implementation of the AGMCE duty hours rule was associated with fewer hours spent in the hospital, which inevitably decreased hands-on clinical education. 34 In our study, there was no change in the average weekly working hours per resident and fewer working hours violations in the 12-hour on-call system. Reduction in the working hour violations without affecting the average working hours per week led to improved QoL, education, research, and surgical experience among the urology residents.…”

Section: Discussioncontrasting

confidence: 47%

Urology Residents’ Perspectives on the In-House On-Call Systems: A Study in an Accredited Academic Center

Khalil

Ibrahim

Aldeeb

et al. 2022

Qatar Medical Journal

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Introduction: Medical education and training are crucial in maintaining patients’ safety and improving patient care quality. Multiple studies have evaluated the effects of restrictive policies on the resident's quality of life and education. Due to the compiling data and the fact that these trials evaluated programs with a substantial number of residents, it remains uncertain whether these conclusions can be extended to urology programs with a small number of residents. Multiple on-call systems have been adopted in residency programs across the world. This study evaluated the residents’ quality of life, clinical experience, and education upon transitioning from 24-hour to 12-hour in-house on-call systems. Methods and materials: In this observational and questionnaire-based study, the effect of the transition from 24-hour to 12-hour in-house on-call systems was compared in terms of the resident's quality of life and education, surgical case volume, and working hours’ rules compliance. Quality of life and education : We adopted a validated survey based on a 5-point Likert scale to assess the residents’ perception of the transition to a 12-hour on-call system on their quality of life and education. Surgical case volume : We extracted the number of cases the residents operated on from the operating theater database at our institution. Working hours: compliance and violations : The weekly working hours, compliance, and violations per ACGME-I rules were collected from the MedHub platform. Results: Quality of life and education: Residents rated the 12-hour on-call system superior in terms of quality of life, education, and surgical case volume. Surgical case volume : There was a 45% increment in the surgical case volume ( p = 0.04) with the 12-hour on-call system. Working hours: compliance and violations There was no significant difference in the mean weekly working hours ( p = 0.1). However, the total number of duty hours violations decreased in the 12-hour on-call system. Conclusion: The 12-hour system is a better alternative to the 24-hour system in terms of the resident's quality of life, education, surgical case volume, and compliance with duty hour rules.

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Section: Discussioncontrasting

confidence: 47%

Urology Residents’ Perspectives on the In-House On-Call Systems: A Study in an Accredited Academic Center

Khalil

Ibrahim

Aldeeb

et al. 2022

Qatar Medical Journal

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“…24,25 Participant comments around potential shiftwork mentality in US trainees are consistent with the literature on the effect of work hour limits and differences in perceptions by US trainees and faculty. [26][27][28][29][30] Themes and Culture of Medical Training and Practice…”

Section: Themes and Acgme Core Requirementsmentioning

confidence: 99%

“…This contrasts with the views of US trainees, who value the improved work-life balance afforded by work hour limits, 33,34 though the comments of US faculty on work hour limits are more ambivalent. 27,30 The Japanese self-sacrifice that extends through one's medical career has been explained as a core quality of Bushido, the moral code that characterized samurai behavior; while Japanese society is changing, this heritage continues to influence physicians and patients' expectations of them. 35,36 Intertwined with this attitude is the Japanese tradition of afterhours socializing with bosses and coworkers.…”

Section: Themes and Acgme Core Requirementsmentioning

confidence: 99%

Contrasting Residency Training in Japan and the United States From Perspectives of Japanese Physicians Trained in Both Systems

Heist

Torok

2019

Journal of Graduate Medical Education

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Background International medical graduates (IMGs) have significant exposure to clinical training in their home country, which provides opportunity for international comparison of training experiences. One relevant IMG population is Japanese physicians who have completed some training before entering residency programs in the United States and desire to improve medical education in Japan. Objective We examined Japanese IMGs' perceptions of the respective attributes of residency in the United States and Japan. Methods Individual semistructured interviews were conducted with 33 purposively sampled Japanese IMGs who had completed training. We used exploratory thematic analysis, iterative data collection, and thematic analyses with constant comparison. Results Comments were organized into 3 categories: (1) attributes of US residency preferable to Japanese residency; (2) attributes of residency training with no clear preference for the US or Japanese systems; and (3) attributes of Japanese residency preferable to US residency. Within each category, we matched themes to residency program requirements or culture of medical training. Main themes include high regard for Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements, with emphasis on efficient achievement of clinical competency through graded responsibility, contrasted with preference expressed for a Japanese training culture of increased professional commitment facilitated by a lack of work hour limits and development of broad clinician skills, including bedside procedures and radiology interpretation. Conclusions Japanese training culture contrasts with a US model that is increasingly focused on work-life balance and associated compartmentalization of patient care. These findings enhance our understanding of the global medical education landscape and challenges to international standardization of training.

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“…A literature review revealed numerous studies evaluating the training of registrars in other specialties in countries around the world. 6,7,8 There are also examples of studies that have been conducted in developing countries, such as India, specifically assessing the training of ophthalmologists. 9 There are no published studies on this topic of ophthalmology training in South Africa.…”

Section: Settingmentioning

confidence: 99%

The ophthalmology postgraduate training programme in South Africa: The registrars’ perspective

Majola

2019

Afr. vis. eye health

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Background: In South Africa, to become an ophthalmologist, one must successfully complete a 4-year postgraduate training programme as a registrar. This training has been offered at different institutions around the country for many years without ever being scrutinised.Aim: The aim of this study was to evaluate the training methods and platforms, overall satisfaction levels, problems and solutions pertaining to postgraduate ophthalmology training as identified by ophthalmology registrars.Setting: The study was conducted in all the institutions across South Africa offering ophthalmology postgraduate training.Methods: This was an educational evaluation study. The data collection instrument used was a questionnaire created using SurveyMonkey.com and sent via email to all ophthalmology registrars, including supernumerary candidates. Ethical approval was granted by the university’s Biomedical Research Ethics Committee.Results: There was a 48% response rate to the survey. Registrars were satisfied that they had received adequate teaching and support, although there was room for improvement. The common problems that impacted the quality of training, as cited by the registrars, were staff shortages, large patient numbers as well as old and broken-down infrastructure or equipment. Despite 86% of the registrars spending at least 5–10 h a week in theatre, 13.3% indicated that they had no supervision during that time. Access to teaching materials (journals, library and Internet) was not available to 34% of the respondents.Conclusion: Registrars were generally satisfied with their training, but major problems that negatively affect their time as trainees were highlighted. Cooperation between registrars, universities, heads of departments and the department of health will be important to remedy this situation.

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A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

Cited by 11 publications

References 19 publications

Urology Residents’ Perspectives on the In-House On-Call Systems: A Study in an Accredited Academic Center

Urology Residents’ Perspectives on the In-House On-Call Systems: A Study in an Accredited Academic Center

Contrasting Residency Training in Japan and the United States From Perspectives of Japanese Physicians Trained in Both Systems

The ophthalmology postgraduate training programme in South Africa: The registrars’ perspective

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