1887
  1. Home
  2. A-Z Publications
  3. Qatar Medical Journal
  4. Volume 2022, Issue 4
  5. Article
Volume 2022, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

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.

: 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.

: We extracted the number of cases the residents operated on from the operating theater database at our institution.

: The weekly working hours, compliance, and violations per ACGME-I rules were collected from the MedHub platform.

Results: Residents rated the 12-hour on-call system superior in terms of quality of life, education, and surgical case volume.

: There was a 45% increment in the surgical case volume ( = 0.04) with the 12-hour on-call system.

There was no significant difference in the mean weekly working hours ( = 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.

© 2022 Khalil, Ibrahim, Aldeeb, Mohamed, Salah, Aboumarzouk, Al-Naimi, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2022.49
2022-11-09
2024-11-12
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2022/4/qmj.2022.49.html?itemId=/content/journals/10.5339/qmj.2022.49&mimeType=html&fmt=ahah

References

  1. Hamad Medical Corporation. Our accreditations Available from: https://www.hamad.qa/EN/About-Us/Our-Accreditations/Pages/default.aspx [Accessed 23 April 2022].
  2. Chehab MA, Selim NA. Impact of ACGME-I accreditation on patient outcomes at Hamad Medical Corporation: A call for evidence. Oman Med J. 2019; 34:(1):81–82. doi: 10.5001/omj.2019.15. PMID: 30671191; PMCID: PMC6330189.
     [Google Scholar]
  3. Goodman A. The development of the Qatar Healthcare System: a review of the literature. Int J Clin Med. 2015; 06:(3):177–185.
     [Google Scholar]
  4. Accreditation Council for Graduate Medical Education 2020 Strategic Plan Summary. https://www.acgme.org/globalassets/pfassets/publicationspapers/strategic-plan-summary.pdf..
  5. Desai SV, Asch DA, Bellini LM, Chaiyachati KH, Liu M, Sternberg AL, et al., Education outcomes in a dutyhour flexibility trial in internal medicine.N Engl J Med. 2018; 378:(16):1494–1508.
     [Google Scholar]
  6. Basner M, Asch DA, Shea JA, Bellini LM, Carlin M, Ecker AJ, et al., Sleep and alertness in a duty-hour flexibility trial in internal medicine. N Engl J Med. 2019; 380:(10):915–923.
     [Google Scholar]
  7. Bilimoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, et al., National cluster-randomized trial of duty-hour flexibility in surgical training. N Engl J Med. 2016; 374:(8):713–727.
     [Google Scholar]
  8. Hamad Medical Corporation.Hospitals and Services Available from: https://site.hamad.qa/EN/Hospitals-and-services/Pages/default.html [Accessed 23 April 2022].
  9. Moore GP, Talarico S, Kempinska A, Lawrence SE, Weisz DE. An innovative on-call system for paediatric residency programs: the alternate night float. Paediatr Child Health. 2015; 20:(9):77–81. doi: 10.1093/pch/20.2.77. PMID: 25838780; PMCID: PMC4373580.
     [Google Scholar]
  10. Mann SM, Borschneck DP, Harrison MM. Implementation of a novel night float call system: resident satisfaction and quality of life. Can J Surg. 2014; 57:(1):15–20. doi: 10.1503/cjs.017712 .
     [Google Scholar]
  11. Mohapatra A, Bandari J, Orikogbo O, Macleod LC, Jackman SV, Davies BJ, et al., Resident duty hour compliance and sleep after transitioning to a night float system: A prospective observational study in an academic urology program. Urol Pract, 2021; 8:(3):409–416. https://doi.org/10.1097/upj.0000000000000217.
     [Google Scholar]
  12. Desai SV, Feldman L, Brown L, Dezube R, Yeh HC, Punjabi N, et al., Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial. JAMA Intern Med. 2013; 173:(8):649–655. doi: 10.1001/jamainternmed.2013.2973. PMID: 23529771.
     [Google Scholar]
  13. (2010) 5-Point Likert Scale. In: Preedy V.R., Watson R. R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_6363.
  14. Important changes to services in Qatar's healthcare system. Available at: https://www.moph.gov.qa/english/mediacenter/News/Pages/NewsDetails.aspx?ItemId = 104. [Accessed 23 April 2022].
  15. The ACGME's Approach to Limit Resident Duty Hours 12 Months After Implementation: A Summary of Achievements. https://www.acgme.org/globalassets/PFAssets/PublicationsPapers/dh_dutyhoursummary2003-04.pdf.
  16. Ibrahim NK, Mahnashi M, Al-Dhaheri A, Al-Zahrani B, Al-Wadie E, Aljabri M, et al., Risk factors of coronary heart disease among medical students in King AbdulAziz University, Jeddah, Saudi Arabia. BMC Public Health. 2014; 14:411.
     [Google Scholar]
  17. Firth-Cozens J. Medical student stress. Med Educ. 2001; 35:(1):6–7.
     [Google Scholar]
  18. Saipanish R. Stress among medical students in a Thai medical school. Med Teach. 2003; 25:(5):502–506.
     [Google Scholar]
  19. Rosal MC, Ockene IS, Ockene JK, Barrett SV, Ma Y, Hebert JR. A longitudinal study of students’ depression at one medical school. Acad Med. 1997; 72:(6):542–546.
     [Google Scholar]
  20. Mane AB, Krishnakumar M, Niranjan Paul C, Hiremath Shashidhar G, Mane AB. Differences in perceived stress and its correlates among students in professional courses. J Clin Diagn Res. 2011;5:1221–8233.
     [Google Scholar]
  21. Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea. Acad Med. 2010; 85:(8):1384–1390.
     [Google Scholar]
  22. Afana A, Ghannam J, Ho EY, Al-Khal A, Al-Arab B, Bylund CL. Burnout and sources of stress among medical residents at Hamad Medical Corporation Qatar. Eas Mediterr Health J. 2017; 23:(1):40–45. doi: 10.26719/2017.23.1.40 .
     [Google Scholar]
  23. Picciano A, Guth L, Winter RO. A 3-year study of resident reaction to 2011 ACGME work hour rules in a family medicine residency. Primer. 2018;2:12. doi: 10.22454/PRiMER.2018.915876 .
     [Google Scholar]
  24. Quillin RC 3rd, Pritts TA, Hanseman DJ, Edwards MJ, Davis BR. How residents learn predicts success in surgical residency. J Surg Educ. 2013; 70:(6):725–730. doi: 10.1016/j.jsurg.2013.09.016. PMID: 24209648.
     [Google Scholar]
  25. Maruthappu M, Gilbert BJ, El-Harasis MA, Nagendran M, McCulloch P, Duclos A, et al., The influence of volume and experience on individual surgical performance: a systematic review. Ann Surg. 2015; 261:(4):642–647. doi: 10.1097/SLA.0000000000000852. PMID: 25072442.
     [Google Scholar]
  26. Lees MC, Zheng B, Daniels LM, White JS. Factors affecting the development of confidence among surgical trainees. J Surg Educ. 2019; 76:(3):674–683. doi: 10.1016/j.jsurg.2018.10.016. Epub 23 Nov 2018. PMID: 30477903.
     [Google Scholar]
  27. Scott JK, Bhattacharya SD, Giles WH. Comparison of operative experiences of PGY-1 and PGY-2 general surgery residents during night-float vs. 24-hour call systems. J Surg Educ. 2021; 78:(6):e56-e61. doi: 10.1016/j.jsurg.2021.08.010. Epub 2021 Sep 3. PMID: 34489201.
     [Google Scholar]
  28. Jamal MH, Rousseau MC, Hanna WC, Doi SA, Meterissian S, Snell L. Effect of the ACGME duty hours restrictions on surgical residents and faculty: a systematic review. Acad Med. 2011; 86:(1):34–42. doi: 10.1097/ACM.0b013e3181ffb264. PMID: 21099662.
     [Google Scholar]
  29. Kashner TM, Henley SS, Golden RM, Byrne JM, Keitz SA, Cannon GW, et al., Studying the effects of ACGME duty hours limits on resident satisfaction: results from VA learners' perceptions survey. Acad Med. 2010; 85:(7):1130–1139. doi: 10.1097/ACM.0b013e3181e1d7e3. PMID: 20592508.
     [Google Scholar]
  30. Ragel BT, Piedra M, Klimo P, Burchiel KJ, Waldo H, McCartney S, et al., An ACGME duty hour compliant 3-person night float system for neurological surgery residency programs.J Grad Med Educ. 2014; 6:(2):315–319. doi: 10.4300/JGME-D-13-00172.1. PMID: 24949139; PMCID: PMC4054734.
     [Google Scholar]
  31. Adin CA, Fogle CA, Marks SL. Duty hours restriction for our surgical trainees: an ethical obligation or a bad idea? Vet Surg. 2018; 47:(3):327–332. doi: 10.1111/vsu.12781. Epub 19 Feb 2018. PMID: 29457248.
     [Google Scholar]
  32. Al-Mohammed A, Al Mohanadi D, Rahil A, Elhiday AH, Al Khal A, Suliman S. Evaluation of progress of an ACGME-International Accredited Residency Program in Qatar. Qatar Med J. 2020; 2020:(1):6. doi: 10.5339/qmj.2020.6. PMID: 32300550; PMCID: PMC7147266.
     [Google Scholar]
  33. Ahmed Alhaneedi G, Alhammoud A, Hameed S, Al Ateeq Al Dosari M, Alkhal A. Does restructuring the research curriculum of orthopedic training program affect the research performance? EVIDENCE FROM QATAR Int. J Adv Res. 2021; 9:(1):950–956.
     [Google Scholar]
  34. Nevin CR, Cherrington A, Roy B, Daly DD, Rodriguez JM, Patel M, et al., A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards.BMC Med Educ 2014;14:84. doi: 10.1186/1472-6920-14-84 .
     [Google Scholar]
  35. Baldwin K, Namdari S, Donegan D, Kamath AF, Mehta S. Early effects of resident work-hour restrictions on patient safety: a systematic review and plea for improved studies. J Bone Joint Surg Am. 2011; 93:(2):e5.
     [Google Scholar]
  36. Fletcher KE, Reed DA, Arora VM. Patient safety, resident education and resident well-being following implementation of the 2003 ACGME duty hour rules.. J Gen Intern Med. 2011; 26:(8):907-919.
     [Google Scholar]
  37. Gopaldas RR, Huh J, Bakaeen FG, Wang XL, Coselli JS, LeMaire SA, et al., The impact of resident work-hour restrictions on outcomes of cardiac operations.J Surg Res. 2009; 157:(2):268–274.
     [Google Scholar]
  38. Awan M, Zagales I, McKenney M, Kinslow K, Elkbuli A. ACGME 2011 Duty hours restrictions and their effects on surgical residency training and patients outcomes: A systematic review. J Surg Educ. 2021; 78:(6):e35-e46. doi: 10.1016/j.jsurg.2021.06.001. Epub 25 Jun 2021. PMID: 34183278.
     [Google Scholar]
  39. Ahmed N, Devitt KS, Keshet I, Spicer J, Imrie K, Feldman L, et al., A systematic review of the effects of resident duty hour restrictions in surgery. Ann Surg. 2014; 259:(6):1041–1053 doi: 10.1097/SLA.0000000000000595 .
     [Google Scholar]
  40. Salgado SM, Katz JT, Pelletier SR, Goodberlet M, Kelly J, Duperreault M, et al., Impact of extended duty hours on perceptions of care and objective patient outcomes. J Patient Saf. 2022; 18:(6), e938–e946. doi: 10.1097/PTS.0000000000000988. Epub ahead of print. PMID: 35152234.
     [Google Scholar]
  41. McGahan BG, Hatef J, Shaikhouni A, Leonard J, Grossbach AJ, Lonser RR, et al., Resident night float or 24-hour call hospital coverage: impact on training, patient outcome, and length of stay. J Surg Educ. 2021:S1931-7204(21)00326-3. doi: 10.1016/j.jsurg.2021.11.008. Epub ahead of print. PMID: 34866033.
     [Google Scholar]
/content/journals/10.5339/qmj.2022.49
Loading
Urology Residents’ Perspectives on the In-House On-Call Systems: A Study in an Accredited Academic Center
Qatar Medical Journal 2022, 49 (2022); https://doi.org/10.5339/qmj.2022.49
/content/journals/10.5339/qmj.2022.49
/content/journals/10.5339/qmj.2022.49
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): 12-hour on-call system, on-call systems, postgraduate training, quality of life, Surgical education and urology Residency program

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error