Collins Jannette, Gruppen Larry D, Bailey Janet E, Bokhari Syed Ahmad Jamal, Paladin Angelisa M, Robbins Jessica, White Richard D
Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman Street, P.O. Box 670761, Cincinnati, OH 45267-0761.
Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI.
Acad Radiol. 2014 Jul;21(7):842-50. doi: 10.1016/j.acra.2013.10.022. Epub 2014 Apr 13.
To compare programs with and without 24-hour/7 days a week/365 days a year (24/7/365) in-house radiologist coverage regarding resident perceptions of their on-call experience, volume of resident dictations on call, and report turnaround time.
Residents from six academic radiology departments were invited to participate in an 11-item online survey. Survey items were related to workload, level of autonomy, faculty feedback, comfort level, faculty supervision, and overall educational experience while on call from 8 pm to 8 am. Each site provided data on imaging volume, radiologist coverage, volume of examinations dictated by residents, number of residents on call, and report turnaround time from 8 pm to 8 am. F-ratios and eta-squares were calculated to determine the relationships between dependent and independent variables. A P value < .05 was considered statistically significant.
A total of 146 (67%) of 217 residents responded. Residents in programs with 24/7/365 in-house radiologist coverage dictated a lower percentage of examinations (46%) compared with other residents (81%) and rated faculty feedback more positively (mean 3.8 vs. 3.3) but rated their level of autonomy (mean 3.6 vs. 4.5) and educational experience (mean 3.6 vs. 4.2) more negatively (all P < .05). Report turnaround time was lower in programs with 24/7/365 coverage than those without (mean 1.7 hours vs. 9.1 hours). The majority of resident comments were negative and related to loss of autonomy with 24/7/365 coverage.
More rapid report turnaround time related to 24/7/365 coverage may come at the expense of resident education.
比较全年无休(24/7/365)内部有放射科医生值班的方案与无该值班安排的方案,以了解住院医师对其值班经历的看法、值班期间住院医师的口述报告量以及报告周转时间。
邀请来自六个学术放射科的住院医师参与一项包含11个项目的在线调查。调查项目涉及晚上8点至早上8点值班期间的工作量、自主程度、教员反馈、舒适程度、教员监督以及总体教育体验。每个站点提供了晚上8点至早上8点的影像量、放射科医生值班情况、住院医师口述的检查量、值班住院医师人数以及报告周转时间的数据。计算F比率和eta平方以确定因变量和自变量之间的关系。P值<0.05被认为具有统计学意义。
217名住院医师中有146名(67%)做出回应。与其他住院医师(81%)相比,全年无休内部有放射科医生值班方案中的住院医师口述检查的比例较低(46%),对教员反馈的评价更为积极(平均3.8分对3.3分),但对自主程度(平均3.6分对4.5分)和教育体验(平均3.6分对4.2分)的评价更为负面(所有P<0.05)。全年无休值班方案的报告周转时间低于无该值班安排的方案(平均1.7小时对9.1小时)。大多数住院医师的评论是负面的,且与全年无休值班安排导致自主程度降低有关。
与全年无休值班安排相关的更快报告周转时间可能是以牺牲住院医师教育为代价的。