The European working time directive: implications for subspecialty acute care

Hellawell, GO; Kahn, Linda S.; Mumtaz, Faiz

doi:10.1111/j.1368-5031.2005.00508.x

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…[1][2][3][4] Alongside these initiatives, there has been concern about the impact of reducing hours on the training of junior doctors in surgery and anaesthetics, and physicians have responded with the development of the acute medicine model. [5][6][7][8] A recent editorial in this journal raised concerns over the impact of the anticipated further reduction in working hours to 48 in August 2009.…”

Section: Introductionmentioning

confidence: 99%

The value of the post-take ward round: are new working patterns compromising junior doctor education?

et al. 2009

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-This prospective observational study assessed the impact of the changes in junior doctors' working hours and waiting-time initiatives on teaching and learning opportunities for junior doctors in acute medicine. An audit cycle of post-take ward rounds including all medical admissions to an urban teaching hospital was conducted. During two sevenday periods in July 2006 and 2008, 317 and 354 patients were admitted respectively. In the two-year interval a number of changes were implemented resulting in a significant increase in patients reviewed by a consultant within 24 hours of admission. Target waiting times were being met but there were many missed learning opportunities for junior staff. Senior doctors continue to perform the majority of post-take reviews in the absence of the doctors who had admitted the patient. Similar patterns are likely to be found in other hospitals attempting to balance training with government targets for waiting times and junior doctors' working hours.

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Section: Introductionmentioning

confidence: 99%

The value of the post-take ward round: are new working patterns compromising junior doctor education?

et al. 2009

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“…Most would consider these as core skills for general surgeons, indeed exploring the scrotum is a level 1 general surgical procedure [5]. Clearly there are also potential clinical governance issues given the numbers of patients being managed by juniors with no formal training or competence assessment in emergency urology [6].…”

Section: Introductionmentioning

confidence: 99%

Competency and Training of General Surgery Specialist Registrars in Emergency Urology

Thiruchelvam

Adamson

2006

BJU International

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“…Concern surrounds the training of current junior doctors in all specialities. [12][13][14] While extensive debate at the molecular level surrounds ETC and DCO, there is no published work regarding the training of junior orthopaedic surgeons in the practical application of these philosophies.…”

Section: Training In the Practical Application Of Damage Control And mentioning

confidence: 99%

Training in the practical application of damage control and early total care operative philosophy – perceptions of UK orthopaedic specialist trainees

Eardley¹,

Taylor²,

Parker

2010

annals

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INTRODUCTION Despite improvements in the outcome of individuals sustaining significant injury, the optimum management of fractures in traumatised patients remains an area of debate and publication. There is, however, a paucity of studies regarding the specifics of acquired experience and training of junior orthopaedic surgeons in the practical application of these skills. Our null hypothesis is that, despite alteration in surgical training, the perceived confidence and adequacy of training of UK orthopaedic specialist trainees in the application of damage control orthopaedics (DCO) and early total care (ETC) philosophy is unaffected. PATIENTS AND METHODS A web-based survey was sent to a sample of orthopaedic trainees. From 888 trainees, 222 responses were required to achieve a 5% error rate with 90% confidence. RESULTS A total of 232 responses were received. Trainees reported a high level of perceived confidence with both external fixation and intramedullary devices. Exposure to cases was sporadic although perceived training adequacy was high. A similar pattern was seen in perceived operative role with the majority of trainees expecting to be performing such operations, albeit under varying levels of supervision. In a more complicated case of spanning external fixation for a ‘floating knee, trainees reported a decreased level of perceived confidence and limited exposure. One-third of trainees reported never having been involved in such a case. In contrast to nationally collated logbook data, exposure to and perceived confidence in managing cases involving ETC and DCO were similar. CONCLUSIONS Despite changes in the training of junior orthopaedic surgeons, trainee-reported confidence and adequacy of training in the practical application of DCO and ETC was high. Exposure to cases overall was, however, seen to be limited and there was a suggestion of disparity between current operative experiences of trainees and that recorded in the national trainee logbook.

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The European working time directive: implications for subspecialty acute care

Cited by 8 publications

References 7 publications

The value of the post-take ward round: are new working patterns compromising junior doctor education?

The value of the post-take ward round: are new working patterns compromising junior doctor education?

Competency and Training of General Surgery Specialist Registrars in Emergency Urology

Training in the practical application of damage control and early total care operative philosophy – perceptions of UK orthopaedic specialist trainees

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