Comparison of Operative Experiences of PGY-1 and PGY-2 General Surgery Residents During Night-Float vs. 24-Hour Call Systems

Scott, Jillian K.; Bhattacharya, Syamal D.; Giles, W. Heath

doi:10.1016/j.jsurg.2021.08.010

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…In surgical specialties, most adaptations have sought to optimize resident operative experience in the face of progressively restrictive duty-hour limits. [2][3][4][5][6][7] Our program recently transitioned from a night-float to a 24-hour call schedule by assigning a greater share of overnight call duties to PGY-3 residents. We sought to quantify the effects of this change on formative junior resident clinical experiences both inside and, in the first report to our knowledge, outside of the operating room.…”

Section: Discussionmentioning

confidence: 99%

“…2 To comply with removal of the 88-hour week exemption and to support additional operative experience during junior residency, OHSU reinstituted a modified version of a 24-hour call schedule on July 1, 2019.According to various reports, transitioning to or from night-float and 24-hour call systems increased operative case numbers without changing inpatient mortality indices. [3][4][5][6][7] Switching to a night-float system at OHSU also reduced duty-hour violations, 2 but this finding has not been replicated. Transitions to either system have garnered strong support among residents at various individual programs.…”

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confidence: 99%

“…Transitions to either system have garnered strong support among residents at various individual programs. 2,4,6,8,9 Data comparing the effects of these schedules on resident call-related workload are notably lacking,…”

mentioning

confidence: 99%

“…According to various reports, transitioning to or from night-float and 24-hour call systems increased operative case numbers without changing inpatient mortality indices. [3][4][5][6][7] Switching to a night-float system at OHSU also reduced duty-hour violations, 2 but this finding has not been replicated. Transitions to either system have garnered strong support among residents at various individual programs.…”

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confidence: 99%

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Effects of 24-hour versus night-float call schedules on the clinical and operative experiences of postgraduate year 2 and 3 neurosurgical residents

Bowden

Siler

Shahin

et al. 2022

Neurosurgical Focus

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OBJECTIVE To comply with the removal of the 88-hour week exemption and to support additional operative experience during junior residency, Oregon Health & Science University (OHSU) switched from a night-float call schedule to a modified 24-hour call schedule on July 1, 2019. This study compared the volumes of clinical, procedural, and operative cases experienced by postgraduate year 2 (PGY-2) and PGY-3 residents under these systems. METHODS The authors retrospectively studied billing and related clinical records, call schedules, and Accreditation Council for Graduate Medical Education case logs for PGY-2 and PGY-3 residents at OHSU, a tertiary academic health center, for the first 4 months of the academic years from 2017 to 2020. The authors analyzed the volumes of new patient consultations, bedside procedures, and operative procedures performed by each PGY-2 and PGY-3 resident during these years, comparing the volumes experienced under each call system. RESULTS Changing from a PGY-2 resident–focused night-float call system to a 24-hour call system that was more evenly distributed between PGY-2 and PGY-3 residents resulted in decreased volume of new patient consultations, increased volume of operative procedures, and no change in volume of bedside procedures for PGY-2 residents. PGY-3 residents experienced a decrease in operative procedure volume under the 24-hour call system. CONCLUSIONS Transition from a night-float system to a 24-hour call system altered the distribution of clinical and procedural experiences between PGY-2 and PGY-3 residents. Further research is necessary to understand the impact of these changes on educational outcomes, quality and safety of patient care, and resident satisfaction.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Effects of 24-hour versus night-float call schedules on the clinical and operative experiences of postgraduate year 2 and 3 neurosurgical residents

Bowden

Siler

Shahin

et al. 2022

Neurosurgical Focus

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A Single-resident Experience of Overnight Call Activity at a Multi-site Academic Health System

Klein,

Jackman,

Nelson

2024

Urology

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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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Comparison of Operative Experiences of PGY-1 and PGY-2 General Surgery Residents During Night-Float vs. 24-Hour Call Systems

Cited by 3 publications

References 10 publications

Effects of 24-hour versus night-float call schedules on the clinical and operative experiences of postgraduate year 2 and 3 neurosurgical residents

Effects of 24-hour versus night-float call schedules on the clinical and operative experiences of postgraduate year 2 and 3 neurosurgical residents

A Single-resident Experience of Overnight Call Activity at a Multi-site Academic Health System

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

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