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Coverdill JE, Carbonell AM, Cogbill TH, Fryer J, Fuhrman GM, Harold KL, Hiatt JR, Moore RA, Nakayama DK, Nelson MT, Schlatter M, Sidwell RA, Tarpley JL, Termuhlen PM, Wohltmann C, Mellinger JD. Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: a multi-institutional study of surgical faculty and residents. American journal of surgery. 2011 Jan;201(201). 16-23.
Abstract
Background
the 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.
Methods
questionnaires 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.
Results
residents 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.
Conclusions
the 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.
2011 Elsevier Inc. All rights reserved.