The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

doi:10.1177/2054270416632703

Cited by 27 publications

(24 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reviews of the literature have shown inconsistent results, reporting no effect, negative effect and inconclusive findings . Expert report and opinion, particularly in regard to the European Working Time Directive limit of 48 hours, is strikingly at odds with these neutral findings, identifying disruption to the supervisory relationship as a significant negative educational outcome, amongst others . This divergence may be due to the metrics used to evaluate education outcomes in many of the studies published to date, which are at best proxy measures.…”

Section: Discussionmentioning

confidence: 99%

Supervised workplace learning in postgraduate training: a realist synthesis

2018

View full text Add to dashboard Cite

ContextThis paper presents a realist synthesis of the literature that began with the objective of developing a theory of workplace learning specific to postgraduate medical education (PME). As the review progressed, we focused on informal learning between trainee and senior doctor or supervisor, asking what mechanisms occur between trainee and senior doctor that lead to the outcomes of PME, and what contexts shape the operation of these mechanisms and the outcomes they produce?MethodsWe followed the procedures outlined in the RAMESES Publication Standards for Realist Synthesis. We searched the English‐language literature published between 1995 and 2017 for empirical papers related to informal workplace learning between supervisor and trainee, excluding formal interventions such as workplace‐based assessment. We made a pragmatic decision to exclude general practice training to keep the review within manageable limits.ResultsWe reviewed 5197 papers and selected 90. Synthesis revealed three workplace learning processes occurring between supervisors and trainees, each underpinned by a pair of mechanisms: supervised participation in practice (entrustment and support seeking); mutual observation of practice (monitoring and modelling), and dialogue during practice (meaning making and feedback). These mechanisms result in outcomes of PME, including safe participation in practice, learning skills, attitudes and behaviours and professional identity development. Contexts shaping the outcomes of these mechanisms were identified at individual, interpersonal, local and systems levels.ConclusionsOur realist theory of workplace learning between supervisors and trainees is informed by theory and empirical research. It highlights the two‐way nature of supervision, the importance of trainees’ agency in their own learning and the deleterious effect of fragmented working patterns on supervisor–trainee learning mechanisms. Further empirical research is required to test and refine this theory. In the meantime, it provides a useful framework for the design of supportive learning environments and for the preparation of supervisors and trainees for their roles in workplace learning.

show abstract

Section: Discussionmentioning

confidence: 99%

Supervised workplace learning in postgraduate training: a realist synthesis

2018

View full text Add to dashboard Cite

show abstract

“…The harsh working conditions of resident physicians has received considerable public attention and resulted in subsequent reforms in the regulation of their working hours in Western countries since the 1990s 15 , 16 . Nevertheless, concerns about adequate training and debates over the outcome of patient care continues 17 – 19 . In Taiwan, the issue of long work hours and burnout for physicians has attracted public concern since 2011 because of several cases involving a physician’s sudden death.…”

Section: Introductionmentioning

confidence: 99%

The number and composition of work hours for attending physicians in Taiwan

Chang

Shih

2020

Sci Rep

View full text Add to dashboard Cite

Long work hours among physicians is a worldwide issue in the healthcare arena. Previous studies have largely focused on the work hours of resident physicians rather than those of attending physicians. The purpose of this study was to investigate total work hours and the composition of those work hours for attending physicians across different hospital settings and across different medical specialties through a nationwide survey. This included examining differences in physician workload and its composition with respect to different hospital characteristics, and grouping medical specialties according to the work similarities. A cross-sectional self-reported nationwide survey was conducted from June to September of 2018, and the two questionnaires were distributed to all accredited hospitals in Taiwan. The number of physician work hours in different types of duty shifts were answered by medical specialty in each surveyed hospital. Each medical specialty in a hospital filled only one response for its attending physicians. The findings reveal that the average total work hours per week of an attending physician is around 69.1 h, but the total work hours and their composition of different duty shifts varied among hospital accreditation levels, geographic locations, emergency care responsibilities, and medical specialties. Because of the variance in the number and composition of attending physicians’ work hours, adjusting physician work hours to a reasonable level will be a major challenge for health authority and hospital managers.

show abstract

“…Mainly in Europe, working time restrictions for physicians have been discussed since 1998. 48 Since 2017, the Japanese government has been planning to finally implement an overtime restriction for Japanese hospital physicians; however, a more detailed restriction for the interdiction of continuous all-day work after a night shift and establishing rest periods are needed. Stress related to 'poor structural issues of university hospitals' was a unique stressor of Japanese physicians.…”

Section: Discussionmentioning

confidence: 99%

Work-related stressors among hospital physicians: a qualitative interview study in the Tokyo metropolitan area

et al. 2020

View full text Add to dashboard Cite

ObjectivesWe explored Japanese physicians’ work-related stressors and identified those unique to this population, as well as clarified the influence of cultural and medical system diversity on these stressors to determine the content of future stress-reducing interventions for hospital physicians in Japan.DesignWe conducted a semistructured, face-to-face interview-based qualitative study between August and October 2017. The collected data were analysed using the grounded theory approach.SettingHospitals around the Tokyo metropolitan area, Japan.ParticipantsSixteen hospital physicians (mean age (SD)=33.9 (4.2) years; 11 men, 5 women). Seven worked in internal medicine and nine in surgery.ResultsWe found unique stressors related to the Japanese medical system and culture, such as continuous all-day work after night shifts, and a hierarchical organisational system called Ikyoku. The results also indicated that Japanese physicians shared several stressors with Western physicians, such as sleep deprivation, high pressure and the limits of medicine.ConclusionsOur study clarifies some sources of work-related stressors among hospital physicians in Japan. While the key components of Western interventions might be useful in a Japanese context, the original evidence obtained from this study highlights the necessity of initiating interventions addressing the unique stressors of Japanese physicians. To reduce physicians’ stress and enhance their well-being, psychological interventions for hospital physicians must be introduced in Japan.

show abstract

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014

Cited by 27 publications

References 13 publications

Supervised workplace learning in postgraduate training: a realist synthesis

Supervised workplace learning in postgraduate training: a realist synthesis

The number and composition of work hours for attending physicians in Taiwan

Work-related stressors among hospital physicians: a qualitative interview study in the Tokyo metropolitan area

Contact Info

Product

Resources

About