Department of Surgery,Washington University in Saint Louis, St. Louis, Missouri.
Department of Surgery,Washington University in Saint Louis, St. Louis, Missouri.
J Surg Educ. 2024 Nov;81(11):1522-1528. doi: 10.1016/j.jsurg.2024.07.024. Epub 2024 Sep 1.
Surgical resident schedules are demanding. Despite ACGME requirements that residents be able to attend personal appointments, many residents put off essential health tasks due to work hours. We designed a method for surgical residents to request a "flex" or personal day utilizing an online system for requesting and tracking.
Residents were given 5 days to use during 1 academic year. A float rotation was implemented to cover scheduled absences. We conducted an anonymous REDCap survey pre and postimplementation regarding resident ability to attend personal appointments and wellbeing. The results of these surveys were compared using descriptive statistics, t-test, and chi-square testing.
Single large academic training institution.
Sixty general surgery residents.
Over 9 months, we scheduled 195 flex days and 91% of residents had used the program. The most common uses were travel, time with family/friends, and attending personal health appointments Postimplementation, of residents who needed an appointment, an increased percentage attended a physician (92% vs. 71%, p 0.02), dental (94% vs. 65%, p < 0.01) or mental health (96% vs. 64%, p < 0.01) appointment. A decreased percentage delayed a necessary appointment due to work hours (45% vs. 19.5%, p 0.01), 94% reported improved schedule control, and 100% believed the program was important for wellbeing. When comparing Mayo Wellbeing Index scores pre and postimplementation there was a decrease in the number of trainees reporting high distress (18.8% vs. 29.3%, p 0.03). Postimplementation, our program noted an 80% decrease in the number of duty hours violations (16 vs. 3 violations) and a 12% increase in compliance with the ACGME survey for ability to attend personal appointments.
"Flex" days offer surgical residents improved schedule control and the ability to schedule essential personal appointments. They are feasible, even within large training programs, with significant uptake in our sample.
住院医师的日程安排要求很高。尽管 ACGME 要求住院医师能够参加个人预约，但由于工作时间的原因，许多住院医师推迟了基本的健康任务。我们设计了一种方法，让外科住院医师利用在线系统请求和跟踪来请求“灵活”或个人日。
住院医师在一个学术年中有 5 天的时间使用。实施了浮动轮班制来覆盖预定的缺勤。我们在实施前后进行了一项匿名 REDCap 调查，调查了住院医师参加个人预约和保持健康的能力。使用描述性统计、t 检验和卡方检验比较这些调查结果。
单一大专学术培训机构。
60 名普通外科住院医师。
在 9 个月的时间里，我们安排了 195 个灵活日，91%的住院医师使用了该计划。最常见的用途是旅行、与家人/朋友共度时光和参加个人健康预约。实施后，需要预约的住院医师中有更高比例的人去看医生（92%对 71%，p<0.02）、看牙医（94%对 65%，p<0.01）或看心理健康医生（96%对 64%，p<0.01）。由于工作时间而推迟必要预约的比例下降（45%对 19.5%，p<0.01），94%的人报告说更好地控制了日程，100%的人认为该计划对健康很重要。在比较梅奥幸福感指数得分时，报告高度焦虑的受训者人数有所减少（18.8%对 29.3%，p<0.03）。实施后，我们的计划记录到违规工作时间的次数减少了 80%（16 次对 3 次），遵守 ACGME 调查要求的次数增加了 12%，以确保能够参加个人预约。
“灵活”日为外科住院医师提供了更好的日程控制能力，并能够安排必要的个人预约。即使在大型培训计划中，它们也是可行的，在我们的样本中使用率很高。
