Impact of the European Working Time Directive (EWTD) on the operative experience of surgery residents

Hopmans, Cornelis J.; Hoed, P.T. den; Laan, Lijckle van der; Harst, Erwin van der; Elst, Maarten van der; Mannaerts, Guido H. H.; Dawson, I.; Timman, Reinier; Wijnhoven, Bas P. L.; IJzermans, Jan N.M.

doi:10.1016/j.surg.2014.09.025

Cited by 29 publications

(30 citation statements)

References 42 publications

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“…The remaining 2 years consist of specialty training in one of the following subspecialties: gastrointestinal surgery, surgical oncology, trauma surgery, or vascular surgery. This postgraduate training in general surgery is organized in eight training regions, each consisting of one university hospital and several affiliated district general training hospitals [37–39]. …”

Section: Methodsmentioning

confidence: 99%

Ergonomics in the operating room

et al. 2016

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BackgroundSince the introduction of minimally invasive surgery, surgeons appear to be experiencing more occupational musculoskeletal injuries. The aim of this study is to investigate the current frequency and effects of occupational musculoskeletal injuries on work absence.MethodsAn online questionnaire was conducted among all surgeons affiliated to the Dutch Society for Endoscopic Surgery, Gastrointestinal Surgery, and Surgical Oncology. In addition, this survey was conducted among surgeons, gynaecologists, and urologists of one cluster of training hospitals in the Netherlands.ResultsThere were 127 respondents. Fifty-six surgeons currently suffer from musculoskeletal complaints, and 30 have previously suffered from musculoskeletal complaints with no current complaints. Frequently reported localizations were the neck (39.5 %), the erector spinae muscle (34.9 %), and the right deltoid muscle (18.6 %). Most of the musculoskeletal complaints were present while operating (41.8 %). Currently, 37.5 % uses medication and/or therapy to reduce complaints. Of surgeons with past complaints, 26.7 % required work leave and 40.0 % made intraoperative adjustments. More surgeons with a medical history of musculoskeletal complaints have current complaints (OR 6.1, 95 % CI 1.9–19.6). There were no significant differences between surgeons of different operating techniques in localizations and frequency of complaints, or work leave.ConclusionsDespite previous various ergonomic recommendations in the operating room, the current study demonstrated that musculoskeletal complaints and subsequent work absence are still present among surgeons, especially among surgeons with a positive medical history for musculoskeletal complaints. Even sick leave was necessary to fully recover. There were no significant differences in reported complaints between surgeons of different operating techniques. Almost half of the respondents with complaints made intraoperative ergonomic adjustments to prevent future complaints. The latter would be interesting for future research.

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Section: Methodsmentioning

confidence: 99%

Ergonomics in the operating room

et al. 2016

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“…Reduced working hours and the effects on the medical profession continue to be a highly discussed matter [3, 12–15]. Despite the vital debate between advocates and opponents of this change, our survey indicated that the majority of affected students and staff members are still uncertain if this trend is positive or negative for medical education.…”

Section: Discussionmentioning

confidence: 86%

“…A number of publications have indicated that the current duration of residency programs may not be able to provide the same level of education with reduced working hours [8, 9]. Although these results are not to be considered as final [14, 15] they should, however, alert us to find possibilities to compensate for any possible loss in quality. This may involve the further outsourcing of administrative tasks in order to focus the work of medical doctors on treating patients.…”

Section: Discussionmentioning

confidence: 99%

Restricted working hours in Austrian residency programs

Bergmeister

Aman

Podesser

2018

Wien Klin Wochenschr

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SummaryBackgroundNew regulations for working hours of medical doctors have been implemented in Austria based on the European directive 2003/88/EG, limiting on-duty working hours to 48 h per week. Clinical work is, therefore, substantially reduced compared to previous decades, and little is known on physician and students’ opinions on this matter. We illustrate survey results concerning on-job training, its difficulties, and implications for restricted working hours.MethodsWe conducted an internal survey among M.D. and Ph.D. students and medical staff members at the Medical University of Vienna using the MedCampus system (CAMPUSOnline, Graz, Austria) and SPSS (V.21, IBM Corp, Armonk, NY, USA).ResultsParticipants were 36.5% staff members and 63.5% students. Students rated continuous education of physicians high at 9.19 ± 1.76 and staff members at 8.90 ± 2.48 on a 1–10 (1 unimportant, 10 most important) scale. Students rated limited time resources, while staff considered financial resources as the greatest challenge for in-hospital education. Overall, 28.85% thought that restricted working hours can positively influence education, while 19.04% thought the opposite and 52.11% were undecided.DiscussionConsidering the limited available time and financial resources, education of tomorrow’s medical doctors remains an important but difficult task. While participants of our survey rated education as very important despite its many challenges, the opinions towards limited working hours were not as clear. Given that over 50% are still undecided whether reduced work hours may also positively influence medical education, it clearly presents an opportunity to include the next generations of physicians in this undertaking.

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“…Of the 24 included studies, 19 were from the USA, one from the Netherlands, one from Thailand, one from Spain and two from the UK ( Table ). Sixteen studies from the USA used Accreditation Council for Graduate Medical Education (ACGME) logbook data to assess a national cohort of graduating trainees in a series of cross‐sectional analyses.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of operative experiences of general surgery trainees during training

Elsey

Griffiths

Humes

et al. 2017

Journal of British Surgery

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Background: General surgical training curricula around the world set defined operative numbers to be achieved before completion of training. However, there are few studies reporting total operative experience in training. This systematic review aimed to quantify the published global operative experience at completion of training in general surgery.Methods: Electronic databases were searched systematically for articles in any language relating to operative experience in trainees completing postgraduate general surgical training. Two reviewers independently assessed citations for inclusion using agreed criteria. Studies were assessed for quantitative data in addition to study design and purpose. A meta-analysis was performed using a random-effects model of studies with appropriate data.

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Impact of the European Working Time Directive (EWTD) on the operative experience of surgery residents

Cited by 29 publications

References 42 publications

Ergonomics in the operating room

Ergonomics in the operating room

Restricted working hours in Austrian residency programs

Meta-analysis of operative experiences of general surgery trainees during training

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