Learner Preference of Schedule Type Improves Engagement of Pediatric Residents: Results of a Mixed-Methods Analysis
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ORIGINAL RESEARCH
Learner Preference of Schedule Type Improves Engagement of Pediatric Residents: Results of a Mixed-Methods Analysis Jody N. Huber 1,2 & Gokhan Olgun 1,2 & Lesta D. Whalen 1,2 & Ashley R. Sandeen 1,2 & Deborah T. Rana 3 & Joseph A. Zenel 1,2
# International Association of Medical Science Educators 2020
Abstract Objective Determine whether a call or shift schedule is better for acquiring optimal knowledge and professionalism, while limiting fatigue for pediatric residents during the pediatric intensive care unit (PICU) rotation in a small residency program. Methods This was a prospective, randomized, crossover, mixed-methods study in which pediatric residents were randomized to either a call or shift schedule during their PICU rotation. Attentiveness, bedside care, perceived knowledge, and professionalism were assessed by the resident participants, attending physicians, and nursing staff. Epworth Sleepiness Scale determined the level of resident fatigue. Statistical analysis utilized a t test of unequal variances. Two focus groups were conducted of resident nonparticipants and participants. Graduated resident participants and non-participants were surveyed via anonymous e-mail responses. Results Thirty residents participated in the study and twenty residents were surveyed and participated in a focus group. No major differences were detected between each participating group, whether assigned to a call or shift schedule in regard to perceived knowledge, professionalism, or fatigue. Overall themes from qualitative analysis identified advantages and disadvantages for both work schedules. Participants recognized a learner preference for schedule type depending on level of training, suggesting a shift schedule for junior residents and a call schedule for senior residents. Conclusions There is no difference between the call or shift schedule in regard to residents’ perceived knowledge, professionalism, and fatigue. Participants expressed learner preferences for one schedule over the other, recommending the shift schedule during the PGY-2 year and the call schedule during the PGY-3 year. Keywords Call . Shift . Resident physician . Work hours . PICU
Introduction Resident clinical and educational work hours (formerly known as “duty hours”) have been prominently discussed in Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40670-020-01036-6) contains supplementary material, which is available to authorized users. * Jody N. Huber [email protected] 1
Sanford Children’s Hospital, Sanford Medical Center, 1600 W 22nd St., Sioux Falls, SD 57117, USA
2
University of South Dakota Sanford School of Medicine, E. Clark St., Vermillion, SD 57069, USA
3
University of California San Diego School of Medicine, UCSD Center for Mindfulness, 5060 Shoreham Place, Suite 330, San Diego, CA 92122, USA
the medical education community for over 15 years. Prior to 2003, resident work hours were not monitored closely on a national level. Due to concerns for resident fati
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