Effect of work hours, caseload, shift type, and experience on resident call performance

Area of Science:

• Radiology
• Medical Education
• Quality Assurance

Background:

• Evaluating resident performance is crucial for patient safety.
• Different call structures may impact interpretation quality.

Purpose of the Study:

• To analyze the independent effects of multiple variables on resident call performance.
• To compare discrepancy rates across different radiology resident call types.

Main Methods:

• Cross-sectional review of quality assurance data for radiology residents on call.
• Comparison of clinically significant discrepancies between overnight call (OC), night float (NF), and weekend day call (WD).
• Logistic regression analysis to identify factors associated with increased discrepancy rates.

Main Results:

• Higher discrepancy rates were associated with junior residents, increasing caseload per hour, and weekend shifts.
• Overnight call (OC) had significantly higher discrepancy rates compared to night float (NF).
• Weekend overnight call shifts showed higher discrepancy rates than weekday overnight call shifts.

Conclusions:

• Caseload, resident experience level, and working on weekends are key factors influencing discrepancy rates.
• The traditional overnight call (OC) structure is associated with a higher rate of interpretation discrepancies than the night float (NF) system.
• Overall, clinically significant discrepancy rates are low across all evaluated call types.