A new professionalism? Surgical residents, duty hours restrictions, and shift transitions.
Acad Med. 2010 Oct;85(10 Suppl):S72-5
Authors: Coverdill JE, Carbonell AM, Fryer J, Fuhrman GM, Harold KL, Hiatt JR, Jarman BT, Moore RA, Nakayama DK, Nelson MT, Schlatter M, Sidwell RA, Tarpley JL, Termuhlen PM, Wohltmann C, Mellinger JD
BACKGROUND: Some anticipated that the Accreditation Council for Graduate Medical Education duty hours restrictions would foster a team-focused "new professionalism" among residents. This study explores the prevalence and challenges of a new professionalism and whether they vary by program size. METHOD: Questionnaires distributed in 15 general surgery programs produced an 82% response rate (N = 306); 52 semistructured follow-up interviews were completed. Results include means, percentage who "agree or strongly agree," significance tests, and main themes from the interviews. RESULTS: A new professionalism is limited by residents' reluctance to pass work from day to night teams, unclear guidance regarding stay-or-go decisions during shift transitions, little educational emphasis on sign-outs, and the practice of long hours in the name of professionalism. Program size is largely unassociated with these beliefs and behaviors. CONCLUSIONS: A new professionalism represents a stalled revolution among surgical residents. The new professionalism's emphasis on teamwork requires additional attention to staffing and workload management.
PMID: 20881709 [PubMed - in process]