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Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation

BACKGROUND: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focuse...

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Autores principales: Fang, Michele, Linson, Eric, Suneja, Manish, Kuperman, Ethan F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322644/
https://www.ncbi.nlm.nih.gov/pubmed/28228099
http://dx.doi.org/10.1186/s12909-017-0874-7
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author Fang, Michele
Linson, Eric
Suneja, Manish
Kuperman, Ethan F.
author_facet Fang, Michele
Linson, Eric
Suneja, Manish
Kuperman, Ethan F.
author_sort Fang, Michele
collection PubMed
description BACKGROUND: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents’ workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. METHODS: In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents’ perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. RESULTS: The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p < 0.001) and 5.7(SD 2.0) in FY2015 (p < 0.001). A higher proportion of residents reported “just right” patient volume (64.4%, 91.7%, 96.7% in FY2013, 2014, 2015 respectively p < 0.001), meeting curricular goals (79.9%, 95.0%, 97.2%, in FY2013, 2014 and 2015 respectively p < 0.001), and overall educational value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p < 0.001). CONCLUSIONS: Decreasing resident workload through adding clinical faculty (both staff physician and APPs) was associated with improvements on resident perceived educational value and clinical experience of a medical consultation rotation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-017-0874-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-53226442017-03-01 Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation Fang, Michele Linson, Eric Suneja, Manish Kuperman, Ethan F. BMC Med Educ Research Article BACKGROUND: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents’ workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. METHODS: In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents’ perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. RESULTS: The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p < 0.001) and 5.7(SD 2.0) in FY2015 (p < 0.001). A higher proportion of residents reported “just right” patient volume (64.4%, 91.7%, 96.7% in FY2013, 2014, 2015 respectively p < 0.001), meeting curricular goals (79.9%, 95.0%, 97.2%, in FY2013, 2014 and 2015 respectively p < 0.001), and overall educational value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p < 0.001). CONCLUSIONS: Decreasing resident workload through adding clinical faculty (both staff physician and APPs) was associated with improvements on resident perceived educational value and clinical experience of a medical consultation rotation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-017-0874-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-02-22 /pmc/articles/PMC5322644/ /pubmed/28228099 http://dx.doi.org/10.1186/s12909-017-0874-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Fang, Michele
Linson, Eric
Suneja, Manish
Kuperman, Ethan F.
Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title_full Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title_fullStr Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title_full_unstemmed Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title_short Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
title_sort impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322644/
https://www.ncbi.nlm.nih.gov/pubmed/28228099
http://dx.doi.org/10.1186/s12909-017-0874-7
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