Program director perceptions of surgical resident training and patient care under flexible duty hour requirements

Lily V. Saadat, Allison R. Dahlke, Ravi Rajaram, Lindsey Kreutzer, Remi Love, David D. Odell, Karl Y. Bilimoria, Anthony D. Yang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. Study Design A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. Results One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p < 0.001), continuity of care (98.3% vs 0%; p < 0.001), and resident ability to attend educational activities (74.1% vs 3.4%; p < 0.001). Most PDs in both arms reported that safety of patient care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Conclusions Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours.

Original languageEnglish (US)
Pages (from-to)1098-1105
Number of pages8
JournalJournal of the American College of Surgeons
Volume222
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

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Patient Care
Continuity of Patient Care
Education
Pragmatic Clinical Trials
Safety
Patient Safety
Internship and Residency
Critical Illness
Surveys and Questionnaires

ASJC Scopus subject areas

  • Surgery

Cite this

Program director perceptions of surgical resident training and patient care under flexible duty hour requirements. / Saadat, Lily V.; Dahlke, Allison R.; Rajaram, Ravi; Kreutzer, Lindsey; Love, Remi; Odell, David D.; Bilimoria, Karl Y.; Yang, Anthony D.

In: Journal of the American College of Surgeons, Vol. 222, No. 6, 01.06.2016, p. 1098-1105.

Research output: Contribution to journalArticle

Saadat, LV, Dahlke, AR, Rajaram, R, Kreutzer, L, Love, R, Odell, DD, Bilimoria, KY & Yang, AD 2016, 'Program director perceptions of surgical resident training and patient care under flexible duty hour requirements', Journal of the American College of Surgeons, vol. 222, no. 6, pp. 1098-1105. https://doi.org/10.1016/j.jamcollsurg.2016.03.026
Saadat, Lily V. ; Dahlke, Allison R. ; Rajaram, Ravi ; Kreutzer, Lindsey ; Love, Remi ; Odell, David D. ; Bilimoria, Karl Y. ; Yang, Anthony D. / Program director perceptions of surgical resident training and patient care under flexible duty hour requirements. In: Journal of the American College of Surgeons. 2016 ; Vol. 222, No. 6. pp. 1098-1105.
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abstract = "Background The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ({"}Standard Policy{"}) to flexible, less-restrictive policies ({"}Flexible Policy{"}). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. Study Design A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100{\%} response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. Results One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9{\%} vs 0{\%}; p < 0.001), continuity of care (98.3{\%} vs 0{\%}; p < 0.001), and resident ability to attend educational activities (74.1{\%} vs 3.4{\%}; p < 0.001). Most PDs in both arms reported that safety of patient care (71.8{\%}), continuity of care (94.0{\%}), quality of resident education (83.8{\%}), and resident well-being (55.6{\%}) would be improved with a hypothetical permanent adoption of more flexible duty hours. Conclusions Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours.",
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AU - Saadat, Lily V.

AU - Dahlke, Allison R.

AU - Rajaram, Ravi

AU - Kreutzer, Lindsey

AU - Love, Remi

AU - Odell, David D.

AU - Bilimoria, Karl Y.

AU - Yang, Anthony D.

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N2 - Background The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. Study Design A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. Results One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p < 0.001), continuity of care (98.3% vs 0%; p < 0.001), and resident ability to attend educational activities (74.1% vs 3.4%; p < 0.001). Most PDs in both arms reported that safety of patient care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Conclusions Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours.

AB - Background The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. Study Design A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. Results One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p < 0.001), continuity of care (98.3% vs 0%; p < 0.001), and resident ability to attend educational activities (74.1% vs 3.4%; p < 0.001). Most PDs in both arms reported that safety of patient care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Conclusions Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours.

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