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Academic time at a level 1 trauma center: no resident, no problem?
Kazuhide Matsushima1, Rebecca M Dickinson, Eric W Schaefer
1Division of Trauma, Acute Care and Critical Care Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17036, USA. kmatsushima@hmc.psu.edu
Journal of Surgical Education
|February 28, 2012
Summary
Protected education time (PET) for surgical residents did not impact trauma patient outcomes like mortality or complications. While emergency department length of stay was slightly longer during PET, it was not statistically significant.
Area of Science:
- Trauma Surgery
- Medical Education
- Patient Outcomes
Background:
- Resident work-hour regulations globally do not affect trauma outcomes.
- The impact of protected education time (PET) on trauma patient outcomes remains unstudied.
- This study investigates whether PET affects trauma patient outcomes.
Purpose of the Study:
- To test the hypothesis that protected education time (PET) does not impact trauma patient outcomes.
- To analyze the effect of resident unavailability during PET on trauma care.
Main Methods:
- Retrospective review of trauma patients at an academic level I trauma center.
- Comparison of trauma activations during 3-hour resident PET (Thursdays) versus non-PET weekdays.
- Univariate and multivariate analyses were used to compare outcomes.
Main Results:
- 178 patients (37 PET, 141 non-PET) were analyzed; mean ISS was 16.2.
- No significant differences in mortality, complications, or length of stay (LOS).
- Emergency department length of stay (ED-LOS) trended longer during PET but was not significant (314 vs. 381 minutes).
Conclusions:
- Few trauma activations occur during PET.
- Trauma attendings and APPs can safely manage new trauma activations during PET.
- Potential delays in patient disposition exist; further study on existing trauma inpatients is needed.
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