Surgeons as Educators A Guide for Academic Development and Teaching Excellence

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Table 9.3 Resident-reported satisfaction and perceptions of well-being, education, and patient
safety

Outcome

Standard-

policy group

Flexible-

policy group

P valuea

Odds ratio for

flexible-policy

no./total no.(%) group (95% Cl)b P value

Primary outcomes

Dissatisfaction with

overall quality of

resident educationc

200/1874

(10.7)

194/1768

(11.0)

0.86 1.08

(0.77−1.52)

0.64

Dissatisfaction with

overall well-beingc

226/1876

(12.0)

263/1769

(14.9)

0.10 1.31

(0.99−1.74)

0.06

Secondary outcomes

Dissatisfactionc

With patient safety77/1875 (4.1) 62/1770

(3.5)

0.48 0.85

(0.55−1.31)

0.46

With continuity of

care

188/1876

(10.0)

83/1769

(4.7)

<0.001 0.44

(0.32−0.60)

<0.001

With quality and

ease of handoffs

and transitions in

care

190/1873

(10.1)

124/1766

(7.0)

0.009 0.69

(0.52−0.92)

0.01

With duty-hour

regulations of the

program

161/1876

(8.6)

144/1768

(8.1)

0.74 0.99

(0.71−1.40)

0.97

With work hours

and scheduling

236/1874

(12.6)

214/1767

(12.1)

0.76 0.95

(0.71−1.27)

0.72

With time for rest 280/1875

(14.9)

329/1768

(18.6)

0.08 1.41

(1.06−1.89)

0.02

Perception of negative effect of institutional duty hoursd

On patient safety 491/1891

(26.0)

223/1782

(12.5)

<0.001 0.40

(0.32−0.51)

<0.001

On continuity of

care

1053/1892

(55.7)

339/1786

(19.0)

<0.001 0.16

(0.12−0.21)

<0.001

On clinical-skills

acquisition

688/1888

(36.4)

232/1777

(13.1)

<0.001 0.24

(0.19−0.31)

<0.001

On operative-skills

acquisition

928/1885

(49.2)

337/1781

(18.9)

<0.001 0.22

(0.17−0.27)

<0.001

On resident

autonomy

663/1888

(35.1)

232/1782

(13.0)

<0.001 0.26

(0.20−0.34)

<0.001

On operative

volume

915/1887

(48.5)

330/1778

(18.6)

<0.001 0.22

(0.17−0.28)

<0.001

On availability for

urgent cases

845/1890

(44.7)

266/1783

(14.9)

<0.001 0.20

(0.16−0.25)

<0.001

D.J. Rea and M. Smith