Gender-Based Differences in Surgical Residents' Perceptions of Patient Safety, Continuity of Care, and Well-Being: An Analysis from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial

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• 作者：Kristen A. Ban ; MD^a ; ^b ; ^c ; Jeanette W. Chung ; PhD^a ; Richard S. Matulewicz ; MD ; MS^a ; Rachel R. Kelz ; MD ; MSCE ; FACS^d ; Judy A. Shea ; PhD^e ; Allison R. Dahlke ; MPH^a ; Christopher M. Quinn ; MS^a ; Anthony D. Yang ; MD ; MS ; FACS^a ; Karl Y. Bilimoria ; MD ; MS ; FACS^a ; ^b ; ^{k-bilimoria@northwestern.edu}
• 刊名：Journal of the American College of Surgeons
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：224
• 期：2
• 页码：126-136.e2
• 全文大小：143 K
• 卷排序：224

文摘

Little is known about gender differences in residency training experiences and whether duty hour policies affect these differences. Using data from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial, we examined gender differences in surgical resident perceptions of patient safety, education, health and well-being, and job satisfaction, and assessed whether duty hour policies affected gender differences.Study DesignWe compared proportions of male and female residents expressing dissatisfaction or perceiving a negative effect of duty hours on aspects of residency training (ie patient safety, resident education, well-being, job satisfaction) overall and by PGY. Logistic regression models with robust clustered SEs were used to test for significant gender differences and interaction effects of duty hour policies on gender differences.ResultsFemale PGY2 to 3 residents were more likely than males to be dissatisfied with patient safety (odds ratio [OR] = 2.50; 95% CI, 1.29–4.84) and to perceive a negative effect of duty hours on most health and well-being outcomes (OR = 1.51–2.10; all p < 0.05). Female PGY4 to 5 residents were more likely to be dissatisfied with resident education (OR = 1.56; 95% CI, 1.03–2.35) and time for rest (OR = 1.55; 95% CI, 1.05–2.28) than males. Flexible duty hours reduced gender differences in career dissatisfaction among interns (p = 0.028), but widened gender differences in negative perceptions of duty hours on patient safety (p < 0.001), most health and well-being outcomes (p < 0.05), and outcomes related to job satisfaction (p < 0.05) among PGY2 to 3 residents.ConclusionsGender differences exist in perceptions of surgical residency. These differences vary across cohorts and can be influenced by duty hour policies.