University of Tennessee College of Medicine Chattanooga, Department of Surgery, Chattanooga, Tennessee.
University of Tennessee College of Medicine Chattanooga, Department of Surgery, Chattanooga, Tennessee.
J Surg Educ. 2021 Nov-Dec;78(6):e56-e61. doi: 10.1016/j.jsurg.2021.08.010. Epub 2021 Sep 3.
We aimed to specifically compare the impact of a night-float system vs. a 24-hour call system on the number and types of cases performed by PGY-1 and PGY-2 general surgery residents to determine if both of these schedules could meet the ACGME first two-year 250 case minimum requirement, and if so, which schedule provided the best operative experience for PGY-1 and PGY-2 residents.
This is a retrospective review of call schedules and operative case logs of PGY-1 and PGY-2 general surgery residents. Residents were separated into two groups based on type of call schedule: 24-hour vs. night-float. The case logs of PGY-1 and PGY-2 residents were obtained from the ACGME Case Log System and data analysis was performed between the two groups.
This study was performed at a general surgery residency at a hybrid academic center.
Forty-three residents met inclusion criteria. Twenty-three were part of the night-float system and 20 were part of the 24-hour call system.
Total cases and major cases for PGY-1 and PGY-2 years were compared between the two groups. The 24-hour call group had a significantly higher total number of cases than the night-float group (646.0 ± 181.5 vs. 504.8 ±148.9, p = 0.008). Major cases were also significantly higher in the 24-hour call group than the night-float group (418.5 ± 99.6 vs. 355 ± 99.5, p = 0.043).
Both the 24-hour call and night-float systems were able to meet the ACGME first two year 250 case minimum requirement as well as follow work-hour guidelines. The 24-hour call system was associated with PGY-1 and PGY-2 residents having a better operative experience than the night-float system.
本研究旨在比较夜间轮班制与 24 小时值班制对住院医师第 1 年和第 2 年普外科住院医师完成的病例数量和类型的影响，以确定这两种方案是否都能满足 ACGME 前两年 250 例的最低要求，如果可以，哪种方案为住院医师第 1 年和第 2 年提供了更好的手术经验。
这是一项回顾性研究，分析了住院医师第 1 年和第 2 年普外科住院医师的值班时间表和手术记录。根据值班时间表的类型，住院医师分为两组：24 小时值班制与夜间轮班制。住院医师第 1 年和第 2 年的手术记录从 ACGME 病例记录系统中获取，对两组数据进行分析。
本研究在一家混合学术中心的普外科住院医师培训项目中进行。
共有 43 名住院医师符合纳入标准。其中 23 名住院医师参加夜间轮班制，20 名住院医师参加 24 小时值班制。
比较了两组住院医师第 1 年和第 2 年的总病例数和主要病例数。24 小时值班组的总病例数明显高于夜间轮班组（646.0±181.5 比 504.8±148.9，p=0.008）。24 小时值班组的主要病例数也明显高于夜间轮班组（418.5±99.6 比 355±99.5，p=0.043）。
24 小时值班制和夜间轮班制都能满足 ACGME 前两年 250 例的最低要求，同时也符合工作时间指南。与夜间轮班制相比，24 小时值班制使住院医师第 1 年和第 2 年的手术经验更好。
