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Medical Science Educator

, Volume 28, Issue 3, pp 473–476 | Cite as

Twenty-Four-Hour Attending Coverage and Its Effect on Trainee Educational Opportunities

  • Jacqueline O’Toole
  • Kathryn Huggett
  • Laurie Leclair
  • Renee Stapleton
Short Communication
  • 25 Downloads

Abstract

Nocturnal ICU staffing gained favor after correlation was shown between intensivist presence and better patient outcomes. We conducted a cross-sectional survey of stakeholders at a tertiary care academic medical center to evaluate the impact of 24-h attending presence on overnight educational environment, learner autonomy, and attending quality of life. Our results showed an improved sense of educational quality along with diminished trainee autonomy. Attending job satisfaction was poor and this was not entirely explained by persistent daytime demands. This identifies areas for initiatives to encourage trainee autonomy and system evaluations of how best to staff attending nocturnal coverage.

Keywords

Resident education Nursing Autonomy Educational environment Nocturnal intensivist Patient safety 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest.

Disclaimer

This work has not been presented in the form of an abstract or poster presentation.

This work has not been previously published online.

References

  1. 1.
    Pronovost P, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA. 2002;288(17):2151–62.CrossRefGoogle Scholar
  2. 2.
    Pronovost P, Thompson DA, Holzmueller CG, Dorman T, Morlock LL. Impact of the leapfrog group’s intensive care unit physician staffing standard. J Crit Care. 2007;22:89–96.CrossRefGoogle Scholar
  3. 3.
    Gajic O, Afessa, Wylam ME, et al. Effect of 24-hour mandatory versus on-demand critical care specialist presence on quality of care and family and provider satisfaction in the intensive care unit of a teaching hospital. Crit Care Med. 2008;36–44.Google Scholar
  4. 4.
    Burchardi H, Moerer O. Twenty-four hour presence of physicians in the ICU. Crit Care. 2001;5:131–7.CrossRefGoogle Scholar
  5. 5.
    Wallace DJ, Angus DC, Barnato AE, Kramer AA, Kahn JM. Nighttime intensivist staffing and mortality among critically ill patients. N Engl J Med. 2012;366(22):2093–101.CrossRefGoogle Scholar
  6. 6.
    Wilcox ME, Harrison DA, Short A, Jonas M, Rowan KM. Comparing mortality among adult, general intensive care units in England with varying intensivist cover patterns: a retrospective cohort study. Crit Care. 2014;18:491–503.CrossRefGoogle Scholar
  7. 7.
    Garland A, Roberts D, Graff L. Twenty-four-hour intensivist presence: a pilot study of effects on intensive care unit patients, families, doctors, and nurses. Am J Respir Crit Care Med. 2012;185(7):738–43.CrossRefGoogle Scholar
  8. 8.
    Scheepers RA, Arah OA, Heineman MJ, Kiki MJ, Lombarts MH. In the eyes of residents good supervisors need to be more than engaged physicians: the relevance of teacher work engagement in residency training. Adv Health Sci Educ. 2015;20:441–55.CrossRefGoogle Scholar
  9. 9.
    Kerlin MP, Small DS, Halpern SD, et al. A randomized trial of nighttime physician staffing in an intensive care unit. N Engl J Med. 2013;368(23):2201–9.CrossRefGoogle Scholar
  10. 10.
    Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.CrossRefGoogle Scholar

Copyright information

© International Association of Medical Science Educators 2018

Authors and Affiliations

  1. 1.Pulmonary and Critical CareJohns Hopkins UniversityBaltimoreUSA
  2. 2.Robert Larner, MD College of Medicine at the University of VermontBurlingtonUSA
  3. 3.University of Vermont Medical Center Division of Pulmonary and Critical Care MedicineBurlingtonUSA

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