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Jamie Dickey

Publications and source records attributed to Jamie Dickey.

7 recordsLinked to original sources

The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions.

BACKGROUND: To assess the impact of work hours' limitations required by the Accreditation Council for Graduate Medical Education (ACGME) on residents' career satisfaction, emotions and attitudes. METHODS: A validated survey instrument was used to assess residents' levels of career satisfaction, emotions and attitudes before and after the ACGME duty hour requirements were implemented. The "pre" implementation survey was distributed in December 2002 and the "post" implementation one in December 2004. Only the latter included work-hour related questions. RESULTS: The response rates were 56% for the 2002 and 72% for the 2004 surveys respectively. Although career satisfaction remained unchanged, numerous changes occurred in both emotions and attitudes. Compared to those residents who did not violate work-hour requirements, those who did were significantly more negative in attitudes and emotions. CONCLUSION: With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them. Graduate medical education leaders must innovate to make the experiences for selected residents improved and still maintain compliance with the work hour requirements.

Accreditation↗

A mid year comparison study of career satisfaction and emotional states between residents and faculty at one academic medical center.

BACKGROUND: The Accreditation Council for Graduate Medical Education's (ACGME) new requirements raise multiple challenges for academic medical centers. We sought to evaluate career satisfaction, emotional states, positive and negative experiences, work hours and sleep among residents and faculty simultaneously in one academic medical center after implementation of the ACGME duty hour requirements. METHODS: Residents and faculty (1330) in the academic health center were asked to participate in a confidential survey; 72% of the residents and 66% of the faculty completed the survey. RESULTS: Compared to residents, faculty had higher levels of satisfaction with career choice, competence, importance and usefulness; lower levels of anxiousness and depression. The most positive experiences for both groups corresponded to strong interpersonal relationships and educational value; most negative experiences to poor interpersonal relationships and issues perceived outside of the physician's control. Approximately 13% of the residents and 14% of the faculty were out of compliance with duty hour requirements. Nearly 5% of faculty reported working more than 100 hours per week. For faculty who worked 24 hour shifts, nearly 60% were out of compliance with the duty-hour requirements. CONCLUSION: Reasons for increased satisfaction with career choice, positive emotional states and experiences for faculty compared to residents are unexplained. Earlier studies from this institution identified similar positive findings among advanced residents compared to more junior residents. Faculty are more frequently at risk for duty-hour violations. If patient safety is of prime importance, faculty, in particular, should be compliant with the duty hour requirements. Perhaps the ACGME should contain faculty work hours as part of its regulatory function.

Academic Medical Centers↗

A comparison study of career satisfaction and emotional states between primary care and speciality residents.

OBJECTIVE: To evaluate career satisfaction, emotional states and positive and negative experiences among residents in primary care and speciality programmes in 1 academic medical centre prior to the implementation of the Accreditation Council for Graduate Medical Education's (ACGME) duty hour requirements. DESIGN: Cross-sectional survey. MEASUREMENTS: All 581 residents in the academic health centre were asked to participate voluntarily in a confidential survey; 327(56%) completed the survey. RESULTS: Compared to their primary care colleagues, speciality residents had higher levels of satisfaction with career choice, feelings of competence and excitement, lower levels of inferiority and fatigue and different perceptions of positive and negative training experiences. However, 77% of all respondents were consistently or generally pleased with their career choices. The most positive residents' experiences related to interpersonal relationships and their educational value; the most negative experiences related to interpersonal relationships and issues perceived to be outside of residents' control. Age and training level, but not gender also influenced career satisfaction, emotional states and positive and negative opinions about residency. CONCLUSIONS: Less satisfaction with career choice and more negative emotional states for primary care residents compared to speciality residents probably relate to the training experience and may influence medical students' selections of careers. The primary care residents, compared to speciality residents, appear to have difficulty in fulfilling their ideals of professionalism in an environment where they have no control. These data provide baseline information with which to compare these same factors after the implementation of the ACGME duty hours' and competency requirements.

Adult↗

Using systems-based practice to integrate education and clinical services.

The authors describe one institution's strategies to implement the Accreditation Council for Graduate Medical Education's (ACGME) Outcomes Project requirements while simultaneously exploring and implementing standards of quality healthcare as endorsed by the Institute of Medicine's (IOM) Crossing the Quality Chasm (2001). Of real interest, application of the authors' institution's paradigm is identical to many of the parameters for system competence as recommended in the IOM's April 2003 report, Health Professions Education: A Bridge to Quality (2003).

Accreditation↗