|
BACKGROUND/RATIONALE:
OBJECTIVE(S):
Objective: To develop observational and interview protocols for use in examination of how duty hour limits in internal medicine and surgery affect provision of clinical care, resident education, and the quality of residents' lives. These protocols will be used to help examine duty hour limits in larger-scale study.
METHODS:
Research Design: The first eight weeks of the study will involve the observation of residents and attending faculty. After that period, ten internal medicine and ten surgical residents will be interviewed along with five internal medicine and five surgical attending faculty. Observation will be conducted in four settings: (1) a general medical floor team at PVAMC; (2) the medical/cardiac intensive care unit at PVAMC, which recently switched to a 12 hour shift system primarily using moonlighters in place of residents; (3) a general surgery floor team; (4) a surgery specialty service floor team. These will provide useful contrasts of how different types of services have coped with the ACGME duty hour restrictions.
Methodology: The observation of residents will be led by Professor Charles Bosk, a sociologist with extensive experience with hospital observational studies and site visits examining resident training, including seminal work on the training of surgeons. Dr. Bosk will direct a team of 4 upper-level graduate students in sociology and anthropology to observe and interview residents. Site visits will consist of (a) direct observation of resident involvement in provision of hospital care; and (b) interviews with residents and attending physicians. At the six-week period of the eight weeks of observations, the observers, under Dr. Volpp's and Dr. Bosk's supervision, will develop an interview protocol for discussing observations with residents. Dr. Volpp will work with Dr. Bosk to develop an interview protocol to be used with attending faculty. The interview protocols will then be piloted during the last week in July and the first week in August. All interviews with providers will be audio-taped and transcribed.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Clinical Relationships: This proposal would be highly responsive to the priority area Health Profession Education and Outcomes and would also be relevant to Healthcare Informatics and Implementation and Management Research. It has the potential to help VA better understand how to respond to work hour restrictions for physicians in training to optimize VA's response to maximize patient safety
PUBLICATIONS:
None at this time.
DRA:
Health Services and Systems
DRE:
Quality of Care, Resource Use and Cost
Keywords:
Practice patterns, Education Research, Trainees
MeSH Terms:
none
|
