THE CONSTRAINTS OF THE 80-HOUR WORK WEEK ON DIDACTIC TEACHING: MAXIMIZING EFFECTIVENESS AND SURGICAL RESIDENT SATISFACTION Jana Cole M.D., Ellen Farrokhi.

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Presentation transcript:

THE CONSTRAINTS OF THE 80-HOUR WORK WEEK ON DIDACTIC TEACHING: MAXIMIZING EFFECTIVENESS AND SURGICAL RESIDENT SATISFACTION Jana Cole M.D., Ellen Farrokhi M.D., Karen Horvath M.D., Doug Brock PhD., Carlos Pellegrini M.D., Gary Mann M.D. University of Washington Department of Surgery

Introduction Service demands of the 80 hour work week can lead to erosion of time for didactic teaching. The challenge is to find new ways to improve education despite time constraints.

Introduction Resident dissatisfaction led us to critically evaluate and change our surgical didactic teaching curriculum.

UW General Surgery Residency 5-7yr University Hospital Program 7 categorical positions 75 residents 5 hospitals

Methods I Curriculum Time Change 1 hour per week Poor attendance All resident levels together PRE POST 4 hours per week Mandatory attendance Juniors (R1,2,3) and Seniors (R4,R5) alternate weeks

Time for Didactic Teaching 51 hrs/resident/yr 116 hrs/resident/yr R1,2,3 R4,5 71 hrs/resident/yr R1,2,3,4,5

Methods I Curriculum Teaching Change Junior (R1,2,3) Senior (R4,5) Literature review Evidence Based Technical Skills Problem Based ACGME Textbook Based Fundamentals Technical Skills Problem Based ACGME

Example Schedule May 4 R1-3 The Acute Abdomen Sabiston pp Faculty: Sinanan Resident: Wolf May 11 R4-5 Laprascopic Colectomy: New Implications Journal Articles posted on Resident Intranet Faculty: Horvath Resident: Drosch May 18 R1-3 Fluids and Electrolytes Sabiston pp Faculty:Nathens Resident:Suver May 25 R4-5 Morbid Obesity and Complications Journal Articles posted on Resident Intranet Faculty: Flum Resident:Chong

Purpose The purpose of this study was to determine the effectiveness and the resident satisfaction with a new didactic teaching curriculum.

Benchmarks Attendance (75%) Satisfaction (75% residents will be satisfied/very satisfied) ABSITE scores (>50 percentile)

Methods II Time point 1: prior to new curriculum Time point 2: 6 mos into new curriculum Time point 3: 1 year after starting new curriculum

Methods II: Survey Satisfaction Attendance/Faculty support ABSITE preparation Fund of knowledge/ Patient care Scale: 1 = strongly disagree 4 = strongly agree

Results

Attendance

Satisfaction with Didactic Teaching Program Scale: 1 = very dissatisfied 4 = very satisfied

Perceived ABSITE Preparation Scale: 1 = strongly disagree 4 = strongly agree

ABSITE Scores

Summary This study supports the effectiveness of our new surgical didactic curriculum. Attendance Resident Satisfaction Perceived ABSITE prep ABSITE scores

Conclusions This study illustrates that we can improve surgical education despite the time constraints of the 80 hour work week.

Thank You