Journal of graduate medical education
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Handoff is the process in which patient care is transitioned from one provider to another. In teaching hospitals, handoffs are frequent, and resident duty hour restrictions have increased the use of night float staff. To date, few studies have focused on long-term sustainability and effectiveness of a handoff quality improvement project. ⋯ We demonstrated sustained improvements in unreported events and uncertainty caused by poor handoffs. Initial improvements in missed content and copy-and-paste behavior that were not sustained suggest a need for ongoing reinforcement and monitoring of handoff quality.
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Medical officers (trainees) in their first to third postgraduate years (PGY-1-3s) work in complex, busy environments, performing tasks that require concentration and application of learned skills. There are frequently competing demands, and being paged is among the most common. ⋯ Pages frequently interrupted direct patient care activities for PGY-1-3 trainees, and a significant proportion of pages were identified as either not requiring immediate attention or not appropriate, resulting in potentially avoidable interruptions to clinical workflow. Alternate means of alerting trainees to nonurgent tasks may reduce interruptions and facilitate patient care.
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The graduate medical education community uses results from the United States Medical Licensing Examination (USMLE) to inform decisions about individuals' readiness for postgraduate training. ⋯ The analysis provided evidence on a national scale that results from the USMLE and the ABA Part 1 were correlated and that success on the latter examination was associated with level of USMLE performance. Both testing programs have been successful in conceptualizing many of the knowledge areas of interest and in developing test content to reflect those areas.
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Burnout in physicians is common, and studies show a prevalence of 30% to 78%. Identifying constructive coping strategies and personal characteristics that protect residents against burnout may be helpful for reducing errors and improving physician satisfaction. ⋯ Burnout is a heterogeneous syndrome that affects many residents. We identified a range of emotional and spiritual coping strategies that may have protective benefit.
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Resident duty hour limits, new requirements for supervision, and an enhanced focus on patient safety have shown mixed effects on resident quality of life, patient safety, and resident competency. Few studies have assessed how recent graduates feel these changes have affected their education. ⋯ Most graduates who responded to the survey felt supervision was equally or more important than limits on resident duty hours. However, 20% of respondents felt that the duty hour standards limited their education. The duty hour and supervision requirements challenge educators to ensure quality education.