American Surgical Association
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19. Medical Students' Perceptions Of Surgical Resident Teaching: Have Duty Hours Regulations Had An Impact?
Aimee E. Brasher, BS*, Shahnaz Chowdhry, MS*, Linnea S. Hauge, PhD*, Richard A. Prinz, MD
Rush University Medical Center, Chicago, IL

OBJECTIVE(S): This study examines medical students’ perceptions of surgical resident teaching on M3 surgical clerkship to determine if a change occurred after the implementation of duty hour regulations.
METHODS: Students from an academic medical center completed end-of-rotation evaluations about surgery residents’ teaching effectiveness, amount of feedback, and quality of interactions. Individual resident teaching evaluations were collected from the year before (2002-03, n=58) and the year after (2003-04, n=66) duty hour regulations. A coding scheme, based on previous studies, was developed to describe resident teaching performance in four areas: teacher, supervisor, physician and interpersonal skills. Pilot data was analyzed to refine the coding system and train coders. Three independent coders rated 124 blinded resident evaluations that included 7335 descriptors, maintaining an interrater agreement of 80%. ANOVAs were conducted to compare data from before and after implementation of duty hour regulations.
RESULTS:After duty hour regulations implementation, there were significantly more negative comments overall (p=.005). Student perceptions about resident teaching activities (p=.001), bedside teaching (p=.007), and resident roles as supervisor (p=.001) and teacher (p=.027) were significantly worse. Although positive comments about resident interpersonal skills increased (p=.01), negative comments about interpersonal skills also increased (p=.02).
CONCLUSIONS:Duty hour regulations have had a significantly negative impact on medical students’ perceptions of surgical resident teaching. Limitations on resident work hours have diminished surgical residents’ teaching contributions. If surgical education programs continue to rely upon resident teaching, they must make this a priority within current regulations and provide opportunities for residents to enhance their teaching and leadership skills.

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