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DOI: 10.1055/s-0028-1091395
Changes in Attendance at Deliveries by Pediatric Residents 2000 to 2005
Publikationsverlauf
Publikationsdatum:
10. Oktober 2008 (online)
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ABSTRACT
We sought to determine if pediatric resident attendance at deliveries for newborn assessment and resuscitation had changed over the years at a training hospital. Data were abstracted from medical records of newborns discharged during the same 6-week periods for 5 consecutive academic years spanning a period before and after resident duty hour regulation changes were implemented. Names of personnel attending deliveries were noted in delivery records. The proportions of deliveries attended by any practitioner were compared by year, as well as the proportion of deliveries attended by practitioner type and training level. A total of 2666 delivery records were reviewed. The proportions of deliveries attended by any practitioner over the 5 years were similar, ranging from 43 to 49%. The proportion of deliveries attended by pediatric residents was highest at 51 to 57% from 2000 to 2002, declined to a low of 5% during 2002 to 2003, and rose to 20 to 23% during 2003 to 2005 (p < 0.0001). The decrease in attendance by residents was compensated by an increase in attendance by hospitalists. At this training institution, pediatric resident attendance at deliveries declined substantially over recent years, likely due in part to resident duty hour regulations and increased use of hospitalists in roles previously held by residents.
KEYWORDS
Duty hour regulations - newborn resuscitation - resident education - pediatric hospitalist
REFERENCES
- 1 Accreditation Council for Graduate Medical Education .ACGME Program Requirements for Graduate Medical Education in Pediatrics. July 1, 2007
- 2 Philibert I, Friedmann P, Williams W T. New requirements for resident duty hours. JAMA. 2002; 288 1112-1114
- 3 Carlson D W, Fentzke K M, Dawson J G. Pediatric hospitalists fill varied roles in the care of newborns. Pediatr Ann. 2003; 32 802-810
- 4 Elliott A C, Reisch J S. Implementing a Multiple Comparison Test for Proportions in a 2xc Crosstabulation in SAS. Paper presented at SUGI 31 Proceedings, San Francisco, CA, 2006
- 5 Zar J H. Biostatistical Analysis. 4th ed. Upper Saddle River, NJ; Prentice Hall 1999
- 6 Fletcher K E, Underwood III W, Davis S Q, Mangrulkar R S, McMahon Jr L F, Saint S. Effects of work hour reduction on residents' lives: a systematic review. JAMA. 2005; 294 1088-1100
- 7 Fletcher K E, Davis S Q, Underwood W, Mangrulkar R S, McMahon Jr L F, Saint S. Systematic review: effects of resident work hours on patient safety. Ann Intern Med. 2004; 141 851-857
- 8 Goitein L, Shanafelt T D, Wipf J E, Slatore C G, Back A L. The effects of work-hour limitations on resident well-being, patient care, and education in an internal medicine residency program. Arch Intern Med. 2005; 165 2601-2606
- 9 Bailit J L, Weisberger A, Knotek J. Resident job satisfaction and quality of life before and after work hour reform. J Reprod Med. 2005; 50 649-652
- 10 Ferguson C M, Kellogg K C, Hutter M M, Warshaw A L. Effect of work-hour reforms on operative case volume of surgical residents. Curr Surg. 2005; 62 535-538
- 11 Kupferman T A, Lian T S. Implementation of duty hour standards in otolaryngology-head and neck surgery residency training. Otolaryngol Head Neck Surg. 2005; 132 819-822
- 12 Spencer A U, Teitelbaum D H. Impact of work-hour restrictions on residents' operative volume on a subspecialty surgical service. J Am Coll Surg. 2005; 200 670-676
- 13 Juretschke L J. New standards for resident duty hours and the potential impact on the neonatal nurse practitioner role. Adv Neonatal Care. 2003; 3 159-161
- 14 Schulman M, Lucchese K R, Sullivan A C. Transition from housestaff to nonphysicians as neonatal intensive care providers: cost, impact on revenue, and quality of care. Am J Perinatol. 1995; 12 442-446
- 15 Reynolds E W, Bricker J T. Nonphysician clinicians in the neonatal intensive care unit: meeting the needs of our smallest patients. Pediatrics. 2007; 119 361-369
- 16 Britton J R. Neonatal nurse practitioner and physician use on a newborn resuscitation team in a community hospital. J Pediatr Health Care. 1997; 11 61-65
- 17 Narang A S, Ey J. The emerging role of pediatric hospitalists. Clin Pediatr (Phila). 2003; 42 295-297
- 18 Leone T A, Rich W, Finer N N. Neonatal intubation: success of pediatric trainees. J Pediatr. 2005; 146 638-641
- 19 Mulcaster J T, Mills J, Hung O R et al.. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003; 98 23-27
- 20 Konrad C, Schupfer G, Wietlisbach M, Gerber H. Learning manual skills in anesthesiology: is there a recommended number of cases for anesthetic procedures?. Anesth Analg. 1998; 86 635-639
- 21 Murphy A A, Halamek L P. Educational perspectives: simulation-based training in neonatal resuscitation. NeoReviews. 2005; 6 e489-e492
Susan R HintzM.D. M.S.
Division of Neonatal and Developmental Medicine, Stanford University
750 Welch Road, Suite #315, Stanford, CA 94304
eMail: srhintz@stanford.edu