Abstract
Purpose
Recent Accreditation Council for Graduate Medical Education policy changes no longer limit the number of consecutive night shifts allowed for trainees. Few studies have examined radiology resident overnight performance over time. This study aimed to compare significant resident-attending discrepancy rates for residents working 2 nonconsecutive versus consecutive weeks of overnight shifts. The authors hypothesized significantly increased week-two discrepancies in the consecutive group.
Methods
For 2020, a retrospective analysis of significant overnight resident-attending discrepancy rates over a 24-week period using database searches was performed for residents self-selecting 2 nonconsecutive versus consecutive weeks. The nonconsecutive group typically had a 7-day mix of days off and day shifts between their night shift weeks. Paired and unpaired t tests were performed with p < 0.05 considered significant.
Results
For the 24 sets of 2 weeks covered by two residents at a time, eight were nonconsecutive and 16 were consecutive. The nonconsecutive group had 75.0% R4 coverage compared to 37.5% for the consecutive group. There were no significant study volume differences between the groups. A total of 27,906 studies (35.3% cross-sectional [CT and MR], 54.9% radiograph plus fluoroscopy, 9.8% US) were performed with 223 discrepancies (0.80%). Overall discrepancies for the nonconsecutive versus consecutive groups were 39/4505 (0.87%) versus 59/9462 (0.62%; p = 0.32) for week one and 46/4732 (1.0%) versus 79/9207 (0.86%; p = 0.60) for week two with no significant differences between the groups by modality.
Conclusion
Residents self-selecting 2 consecutive weeks of overnight shifts do not have increased resident-attending discrepancy rates compared to 2 nonconsecutive weeks.
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Both authors meet all four ICMJE criteria for authorship. Specifically, RR made substantial contributions to the conception and design of the work, the acquisition and analysis of the data, drafting the manuscript, giving final approval for the version to be published, and agreeing to be accountable for all aspects of the work. EP made substantial contributions in the interpretation of data, critical revisions, giving final approval for the version to be published, and agreeing to be accountable for all aspects of the work.
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Ethical approval was waived by the institutional review board of Loma Linda University, who determined that this retrospective project did not qualify as human subject research based on established definitions.
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This project did not require written informed consent as it did not qualify as human subject research as determined by the institutional review board of Loma Linda University.
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This work has not been previously published nor is it under consideration for publication by any other journal. This work was presented as a digital poster on November 28, 2021, at the 107th Scientific Assembly and Annual Meeting of the Radiological Society of North America.
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Rigsby, R., Peters, E. Resident-attending discrepancy rates for two consecutive versus nonconsecutive weeks of overnight shifts. Emerg Radiol 29, 819–823 (2022). https://doi.org/10.1007/s10140-022-02056-y
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DOI: https://doi.org/10.1007/s10140-022-02056-y