Learning in patient-based education sessions: a prospective evaluation.

Full Abstract

OBJECTIVE:
The educational impact of on-call scheduling for physicians in training is not well understood. The benefit of patient-based educational sessions during postcall periods may be enhanced by the greater patient familiarity associated with long on-call shifts, or it may be attenuated by fatigue. The objective was to evaluate the impact of in-house call on cognitive attention, learning, and recall of critical care medicine trainees, before and after a reduction in call period.

DESIGN:
A prospective before and after survey during 8 wks in 2004.

SETTING:
Two critical care units at the Hospital for Sick Children, Toronto.

PARTICIPANTS:
Trainees in a university-affiliated critical care medicine program at the Hospital for Sick Children.

INTERVENTIONS:
Duty hour reduction from 26.5-hr to 18-hr on-call shifts.

MEASUREMENTS AND MAIN RESULTS:
Likert scales were completed after morning educational seminars self-reporting alertness, concentration, how well discussions were followed, and the acquisition of new or practice changing knowledge. Respondents were classified according to how recently they had been on call. Eleven trainees completed 231 questionnaires (80% response rate). Fellows with more recent on-call periods had reduced concentration (p = .002), alertness (p < .0001), and recall of the previous session (p = .009) and followed discussions less well (p = .019). Eighteen-hour shifts were associated with increased postcall alertness (p = .002), concentration (p = .03), and assimilation of discussions (p = .045). However, neither the duration of call nor the length of time since being on call was associated with differences in the acquisition of new theoretical or practice-changing knowledge.

CONCLUSIONS:
Reduced mental attention after being on call is more pronounced after longer shifts. Learning was not affected by shift duration or by how recently trainees were on call. Increased patient familiarity does not augment learning in patient-based medical education.

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Author information

Author/s: Smith, Megan R (MR); Parshuram, Christopher S (CS);

Affiliation: Nottingham University Hospital Trust, Nottingham, UK.

Journal and publication information

Publication Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't

Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med), published in United States. (Language: eng)

Reference: 2008-Jan; vol 9 (issue 1) : pp 86-90

Dates: Created 2008/05/14; Completed 2008/06/26;

PMID: 18477919, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Pediatr Crit Care Med. 2008 Jan;9(1):124-5. (PMID: 18185129)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Attention
Education, Medical - methods
Emergency Medicine - education
Female
Hospitals, Pediatric
Humans
Male
Mental Fatigue - psychology

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