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THE CONSTRAINTS OF THE 80-HOUR WORK WEEK ON DIDACTIC TEACHING: MAXIMIZING EFFECTIVENESS AND SURGICAL RESIDENT SATISFACTION. Jana Cole M.D., Ellen Farrokhi M.D., Karen Horvath M.D., Doug Brock PhD., Carlos Pellegrini M.D., Gary Mann M.D. University of Washington Department of Surgery.
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THE CONSTRAINTS OF THE 80-HOUR WORK WEEK ON DIDACTIC TEACHING: MAXIMIZING EFFECTIVENESS AND SURGICAL RESIDENT SATISFACTION Jana Cole M.D., Ellen Farrokhi M.D., Karen Horvath M.D., Doug Brock PhD., Carlos Pellegrini M.D., Gary Mann M.D. University of Washington Department of Surgery
Introduction • Service demands of the 80 hour work week can lead to erosion of time for didactic teaching. • The challenge is to find new ways to improve education despite time constraints.
Introduction Resident dissatisfaction led us to critically evaluate and change our surgical didactic teaching curriculum.
UW General Surgery Residency • 5-7yr University Hospital Program • 7 categorical positions • 75 residents • 5 hospitals
Methods ICurriculum Time Change PRE POST • 1 hour per week • Poor attendance • All resident levels together • 4 hours per week • Mandatory attendance • Juniors (R1,2,3) and Seniors (R4,R5) alternate weeks
Time for Didactic Teaching R1,2,3 116 hrs/resident/yr R1,2,3,4,5 51 hrs/resident/yr R4,5 71 hrs/resident/yr
Methods ICurriculum Teaching Change Junior (R1,2,3) Senior (R4,5) • Textbook Based • Fundamentals • Technical Skills • Problem Based • ACGME • Literature review • Evidence Based • Technical Skills • Problem Based • ACGME
Purpose The purpose of this study was to determine the effectiveness and the resident satisfaction with a new didactic teaching curriculum.
Benchmarks • Attendance (75%) • Satisfaction (75% residents will be satisfied/very satisfied) • ABSITE scores (>50 percentile)
Methods II Time point 1: prior to new curriculum Time point 2: 6 mos into new curriculum Time point 3: 1 year after starting new curriculum
Methods II: Survey • Satisfaction • Attendance/Faculty support • ABSITE preparation • Fund of knowledge/ Patient care Scale: 1 = strongly disagree 4 = strongly agree
Satisfaction with Didactic Teaching Program Scale: 1 = very dissatisfied 4 = very satisfied
Perceived ABSITE Preparation Scale: 1 = strongly disagree 4 = strongly agree
Summary This study supports the effectiveness of our new surgical didactic curriculum. Attendance Resident Satisfaction Perceived ABSITE prep ABSITE scores
Conclusions This study illustrates that we can improve surgical education despite the time constraints of the 80 hour work week.