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

Megan R Smith¹, Christopher S Parshuram

¹Nottingham University Hospital Trust, Nottingham, UK.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

|May 15, 2008

Summary

Reducing physician training call shifts from 26.5 to 18 hours improved alertness and concentration. However, learning and knowledge acquisition remained unaffected by call duration or recency.

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Area of Science:

Medical Education
Critical Care Medicine
Physician Training

Background:

The impact of on-call scheduling on physician trainees' education is not fully understood.
Longer on-call shifts may increase patient familiarity but also lead to fatigue, potentially affecting learning.
The study aimed to assess the effects of in-house call duration on cognitive functions and learning in critical care medicine trainees.

Purpose of the Study:

To evaluate the impact of in-house call duty on cognitive attention, learning, and recall among critical care medicine trainees.
To compare these effects before and after a reduction in on-call shift duration.
To determine if patient familiarity from longer shifts enhances or if fatigue attenuates educational benefits.

Main Methods:

A prospective before-and-after survey study was conducted over 8 weeks in 2004.
Participants included trainees in a university-affiliated critical care medicine program at the Hospital for Sick Children, Toronto.
On-call duty hours were reduced from 26.5-hour to 18-hour shifts.

Main Results:

Trainees reported reduced concentration, alertness, and recall after longer on-call periods.
Eighteen-hour shifts were associated with improved post-call alertness, concentration, and assimilation of educational discussions.
Neither call duration nor recency of call affected the acquisition of new theoretical or practice-changing knowledge.

Conclusions:

Reduced mental attention following on-call duty is more significant after longer shifts.
Learning and knowledge acquisition in critical care medicine trainees were not significantly impacted by on-call shift duration or recency.
Increased patient familiarity from longer on-call shifts does not appear to augment learning in patient-based medical education settings.