Professionalism in the Twilight Zone: A Multicenter, Mixed-Methods Study of Shift Transition Dynamics in Surgical Residencies.

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ID: 99199
2016
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Ranked #80 of 146 articles by views in Academic medicine : journal of the Association of American Medical Colleges

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Abstract
Duty hours rules sparked debates about professionalism. This study explores whether and why general surgery residents delay departures at the end of a day shift in ways consistent with shift work, traditional professionalism, or a new professionalism.Questionnaires were administered to categorical residents in 13 general surgery programs in 2014 and 2015. The response rate was 76% (N = 291). The 18 items focused on end-of-shift behaviors and the frequency and source of delayed departures. Follow-up interviews (N = 39) examined motives for delayed departures. The results include means, percentages, and representative quotations from the interviews.A minority (33%) agreed that it is routine and acceptable to pass work to night teams, whereas a strong majority (81%) believed that residents exceed work hours in the name of professionalism. Delayed departures were ubiquitous: Only 2 of 291 residents were not delayed for any of 13 reasons during a typical week. The single most common source of delay involved a desire to avoid the appearance of dumping work on fellow residents. In the interviews, residents expressed a strong reluctance to pass work to an on-call resident or night team because of sparse night staffing, patient ownership, an aversion to dumping, and the fear of being seen as inefficient.Resident behavior is shaped by organizational and cultural contexts that require attention and reform. The evidence points to the stunted development of a new professionalism, little role for shift-work mentalities, and uneven expression of traditional professionalism in resident behavior.
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coverdill2016professionalismacademic Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Coverdill, James E;Alseidi, Adnan;Borgstrom, David C;Dent, Daniel L;Dumire, Russell D;Fryer, Jonathan;Hartranft, Thomas H;Holsten, Steven B;Nelson, M Timothy;Shabahang, Mohsen;Sherman, Stanley;Termuhlen, Paula M;Woods, Randy J;Mellinger, John D;
Journal Academic medicine : journal of the Association of American Medical Colleges
Year 2016
DOI
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URL URL not found
Keywords
american journal of sociology american sociological association presidents american sociological review cartel top journal

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