Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: a multi-institutional study of surgical faculty and residents |
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| Authors: | Coverdill James E Carbonell Alfredo M Cogbill Thomas H Fryer Jonathan Fuhrman George M Harold Kristi L Hiatt Jonathan R Moore Richard A Nakayama Don K Nelson M Timothy Schlatter Marc Sidwell Richard A Tarpley John L Termuhlen Paula M Wohltmann Christopher Mellinger John D |
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| Institution: | aDepartment of Sociology, University of Georgia, Athens, GA;bDepartment of Surgery, Medical College of Georgia, Augusta, GA;cDepartment of Surgery, Greenville Hospital System University Medical Center, Greenville, SC;dDepartment of Surgery, Gundersen Lutheran Medical Foundation, LaCrosse, WI;eDepartment of Surgery, Feinberg School of Medicine at Northwestern University, Chicago, IL;fDepartment of Surgery, Atlanta Medical Center, Atlanta, GA;gDepartment of Surgery, Mayo Clinic Arizona, Phoenix, AZ;hDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA;iDepartment of Surgery, University of Tennessee College of Medicine, Chattanooga, TN;jDepartment of Surgery, Mercer University School of Medicine, Macon, GA;kDepartment of Surgery, University of New Mexico, Albuquerque, NM;lDepartment of Surgery, Grand Rapids Medical Education Partners/Michigan State University, Grand Rapids, MI;mDepartment of Surgical Education, Iowa Methodist Medical Center, Des Moines, IA;nDepartment of Surgery, Vanderbilt University, Nashville, TN;oDepartment of Surgery, Wright State University, Dayton, OH;pDepartment of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA |
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| Abstract: | BackgroundThe aim of this study was to explore professional values, value conflicts, and assessments of the Accreditation Council for Graduate Medical Education's duty-hour restrictions.MethodsQuestionnaires distributed at 15 general surgery programs yielded a response rate of 82% (286 faculty members and 306 residents). Eighteen items were examined via mean differences, percentages in agreement, and significance tests. Follow-up interviews with 110 participants were explored for main themes.ResultsResidents and faculty members differed slightly with respect to core values but substantially as to whether the restrictions conflict with core values or compromise care. The average resident–faculty member gap for those 13 items was 35 percentage points. Interview evidence indicates consensus over professional values, a gulf between individualistic and team orientations, frequent moral dilemmas, and concerns about the assumption of responsibility by residents and “real-world” training.ConclusionsThe divide between residents and faculty members over conflicts between the restrictions, core values, and patient care poses a significant issue and represents a challenge in educating the next generation of surgeons. |
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| Keywords: | Duty-hour restrictions Professional values Value conflicts Surgical residents Surgical faculty members |
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