Journal of graduate medical education
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The Accreditation Council for Graduate Medical Education requirements for systems-based practice state residents are expected to participate in identifying system errors and implementing potential systems solutions. The objective of this study was to determine the numbers of perceived errors occurring from patient pass offs between resident physicians in our emergency department. ⋯ Our data suggest emergency medicine residents were able to perceive errors related to transitions of care, describe the types of pass-off errors, and, to a lesser degree, describe the impact these errors have on patients.
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True pediatric emergencies are rare. Because resident work hours are restricted and national attention turns toward patient safety, teaching methods to improve physician performance and patient care are vital. We hypothesize that a critical-care simulation course will improve resident confidence and performance in critical-care situations. ⋯ Our simulation-based pediatric intensive care unit training course improves second-year pediatric residents' comfort level but not performance during codes, as well as their perceived intubation and intraosseous ability. Videotape reviews show discordance between objective performance and self-assessment. Further work is necessary to elucidate the reasons for this difference as well as the appropriate role for simulation in the new graduate medical education climate, and to create new teaching modalities to improve resident performance.
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In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) introduced a set of regulations that mandated a reduction in the number of hours that medical residents can work. These requirements have generated controversy among medical educators, with some expressing concern that reducing resident hours may limit clinical exposure and competency, particularly in surgical specialties. ⋯ The reduction of duty hours has not resulted in a decrease in operative volume as some have predicted. Operative volume in pediatric surgery remained mainly unchanged, whereas operative volume in vascular surgery increased. We explore possible explanations for the observed findings.