Literature DB >> 20540912

Effect of work hours, caseload, shift type, and experience on resident call performance.

Matthew Scott Davenport1, James H Ellis, Shoukofeh H Khalatbari, James D Myles, Katherine A Klein.   

Abstract

RATIONALE AND
OBJECTIVES: To analyze the independent effects of multiple variables on resident call performance.
MATERIALS AND METHODS: Independent radiology resident "on call" cross-sectional imaging interpretation quality assurance (QA) data obtained during a 171-day period at a single tertiary care Level 1 trauma teaching institution was reviewed. Clinically significant resident-faculty discrepancies were compared among three different call types: traditional single-day overnight call (OC, 15 hours/night after 9 daytime hours on weekdays), 7-night nightfloat (NF, 9 hours/night), and weekend day call (WD, 10 hours/day). Logistic regression analyses were performed to evaluate associations.
RESULTS: There were 119 (0.89%) clinically significant resident-faculty discordances from 13,424 cross-sectional interpretations: 56 (0.79%) from 7102 interpretations on 172 OC shifts, 39 (0.85%) from 4567 interpretations on 165 NF shifts, and 24 (1.4%) from 1755 interpretations on 49 WD shifts. Individual residents (n = 20) had a mean discrepancy rate of 0.9% (0.45%-1.9%). Overall, 102 (26.2%) of the shifts had at least one discordance. The following were associated with significantly (P < .001) increased discrepancy rates: junior vs. senior residents (odds ratio [OR] = 1.3 [1.2-1.4]), OC vs. NF (OR = 1.5 [1.3-1.6], WD vs. NF (OR = 1.4 [1.2-1.6]), weekend vs. weekday (OR = 1.3 [1.2-1.4]), and increasing cases/hour (OR = 1.6 [1.5-1.7]). Weekend OC shifts had a higher discrepancy rate (OR 1.3[1.2-1.5], P < .001) than weekday OC shifts despite a shorter workday (15 vs. 24 hours).
CONCLUSION: Increasing caseload, junior residents, and weekends are associated with a significantly higher discrepancy rate. OC is associated with a significantly higher discrepancy rate than NF. Measured discrepancy rates are low, regardless of call type. 2010 AUR. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 20540912     DOI: 10.1016/j.acra.2010.03.006

Source DB:  PubMed          Journal:  Acad Radiol        ISSN: 1076-6332            Impact factor:   3.173


  6 in total

1.  Overnight shift work: factors contributing to diagnostic discrepancies.

Authors:  Tarek N Hanna; Thomas Loehfelm; Faisal Khosa; Saurabh Rohatgi; Jamlik-Omari Johnson
Journal:  Emerg Radiol       Date:  2016-02

2.  Anatomical and/or pathological predictors for the "incorrect" classification of red dot markers on wrist radiographs taken following trauma.

Authors:  R Kranz; P Cosson
Journal:  Br J Radiol       Date:  2014-12-11       Impact factor: 3.039

3.  Reporting of CT cervical spine after office hours by radiology trainees-analysis of discrepancy rates and RADPEER scores.

Authors:  Yet Yen Yan; Jenn Nee Khoo; Tien Jin Tan; Joe Francis; Le Roy Chong; Elizabeth Hui-Ying Chan
Journal:  Emerg Radiol       Date:  2018-03-14

Review 4.  The Effect of Restricting Residents' Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review.

Authors:  Lauren Bolster; Liam Rourke
Journal:  J Grad Med Educ       Date:  2015-09

5.  Increasing neuroradiology exam volumes on-call do not result in increased major discrepancies in primary reads performed by residents.

Authors:  Jared T Verdoorn; Christopher H Hunt; Marianne T Luetmer; Christopher P Wood; Laurence J Eckel; Kara M Schwartz; Felix E Diehn; David F Kallmes
Journal:  Open Neuroimag J       Date:  2015-01-27

6.  Interpretation discrepancies of abdominal imaging by on-call radiology residents: Evaluation of risk factors.

Authors:  Su Jeong Yang; Hee Joong Lim; So Hyun Park; Seung Joon Choi; Young Sup Shim
Journal:  PLoS One       Date:  2022-09-09       Impact factor: 3.752

  6 in total

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