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Podda M, Di Martino M, Pata F, Nigri G, Pisanu A, Di Saverio S, Pellino G, Ielpo B. Global disparities in surgeons' workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study. Updates Surg 2024:10.1007/s13304-024-01859-7. [PMID: 38684574 DOI: 10.1007/s13304-024-01859-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI.
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Affiliation(s)
- Mauro Podda
- Department of Surgical Science, Emergency Surgery Unit, Policlinico Universitario "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, SS 554, Km 4,500, 09042, Cagliari, Monserrato, Italy.
| | - Marcello Di Martino
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Francesco Pata
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Giuseppe Nigri
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Adolfo Pisanu
- Department of Surgical Science, Emergency Surgery Unit, Policlinico Universitario "D. Casula", Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, SS 554, Km 4,500, 09042, Cagliari, Monserrato, Italy
| | - Salomone Di Saverio
- Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Gianluca Pellino
- Department of Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Benedetto Ielpo
- Hepatobiliary Surgery Unit, Hospital del Mar, University Pompeu Fabra, Barcelona, Spain
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Rodriguez Peñaranda N, Eissa A, Ferretti S, Bianchi G, Di Bari S, Farinha R, Piazza P, Checcucci E, Belenchón IR, Veccia A, Gomez Rivas J, Taratkin M, Kowalewski KF, Rodler S, De Backer P, Cacciamani GE, De Groote R, Gallagher AG, Mottrie A, Micali S, Puliatti S. Artificial Intelligence in Surgical Training for Kidney Cancer: A Systematic Review of the Literature. Diagnostics (Basel) 2023; 13:3070. [PMID: 37835812 PMCID: PMC10572445 DOI: 10.3390/diagnostics13193070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
The prevalence of renal cell carcinoma (RCC) is increasing due to advanced imaging techniques. Surgical resection is the standard treatment, involving complex radical and partial nephrectomy procedures that demand extensive training and planning. Furthermore, artificial intelligence (AI) can potentially aid the training process in the field of kidney cancer. This review explores how artificial intelligence (AI) can create a framework for kidney cancer surgery to address training difficulties. Following PRISMA 2020 criteria, an exhaustive search of PubMed and SCOPUS databases was conducted without any filters or restrictions. Inclusion criteria encompassed original English articles focusing on AI's role in kidney cancer surgical training. On the other hand, all non-original articles and articles published in any language other than English were excluded. Two independent reviewers assessed the articles, with a third party settling any disagreement. Study specifics, AI tools, methodologies, endpoints, and outcomes were extracted by the same authors. The Oxford Center for Evidence-Based Medicine's evidence levels were employed to assess the studies. Out of 468 identified records, 14 eligible studies were selected. Potential AI applications in kidney cancer surgical training include analyzing surgical workflow, annotating instruments, identifying tissues, and 3D reconstruction. AI is capable of appraising surgical skills, including the identification of procedural steps and instrument tracking. While AI and augmented reality (AR) enhance training, challenges persist in real-time tracking and registration. The utilization of AI-driven 3D reconstruction proves beneficial for intraoperative guidance and preoperative preparation. Artificial intelligence (AI) shows potential for advancing surgical training by providing unbiased evaluations, personalized feedback, and enhanced learning processes. Yet challenges such as consistent metric measurement, ethical concerns, and data privacy must be addressed. The integration of AI into kidney cancer surgical training offers solutions to training difficulties and a boost to surgical education. However, to fully harness its potential, additional studies are imperative.
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Affiliation(s)
- Natali Rodriguez Peñaranda
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
| | - Ahmed Eissa
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
- Department of Urology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Stefania Ferretti
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
| | - Giampaolo Bianchi
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
| | - Stefano Di Bari
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
| | - Rui Farinha
- Orsi Academy, 9090 Melle, Belgium; (R.F.); (P.D.B.); (R.D.G.); (A.G.G.); (A.M.)
- Urology Department, Lusíadas Hospital, 1500-458 Lisbon, Portugal
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Enrico Checcucci
- Department of Surgery, FPO-IRCCS Candiolo Cancer Institute, 10060 Turin, Italy;
| | - Inés Rivero Belenchón
- Urology and Nephrology Department, Virgen del Rocío University Hospital, 41013 Seville, Spain;
| | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy;
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, 28040 Madrid, Spain;
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, 119435 Moscow, Russia;
| | - Karl-Friedrich Kowalewski
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
| | - Severin Rodler
- Department of Urology, University Hospital LMU Munich, 80336 Munich, Germany;
| | - Pieter De Backer
- Orsi Academy, 9090 Melle, Belgium; (R.F.); (P.D.B.); (R.D.G.); (A.G.G.); (A.M.)
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Giovanni Enrico Cacciamani
- USC Institute of Urology, Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA;
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA
| | - Ruben De Groote
- Orsi Academy, 9090 Melle, Belgium; (R.F.); (P.D.B.); (R.D.G.); (A.G.G.); (A.M.)
| | - Anthony G. Gallagher
- Orsi Academy, 9090 Melle, Belgium; (R.F.); (P.D.B.); (R.D.G.); (A.G.G.); (A.M.)
- Faculty of Life and Health Sciences, Ulster University, Derry BT48 7JL, UK
| | - Alexandre Mottrie
- Orsi Academy, 9090 Melle, Belgium; (R.F.); (P.D.B.); (R.D.G.); (A.G.G.); (A.M.)
| | - Salvatore Micali
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
| | - Stefano Puliatti
- Department of Urology, Azienda Ospedaliero-Universitaria di Modena, Via Pietro Giardini, 1355, 41126 Baggiovara, Italy; (N.R.P.); (A.E.); (S.F.); (G.B.); (S.D.B.); (S.M.)
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Rosta J, Rø KI. Changes in weekly working hours, proportion of doctors with hours above the limitations of European Working Time Directive (EWTD) and time spent on direct patient care for doctors in Norway from 2016 to 2019: a study based on repeated surveys. BMJ Open 2023; 13:e069331. [PMID: 37349097 PMCID: PMC10314479 DOI: 10.1136/bmjopen-2022-069331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/01/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES To compare the total weekly working hours, proportions with work hours above the limitations of European working time directive (EWTD) and time spent on direct patient care in 2016 and 2019 for doctors working in different job positions in Norway. DESIGN Repeated postal surveys in 2016 and 2019. SETTING Norway. PARTICIPANTS Representative samples of doctors; the response rates were 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019. MAIN OUTCOME MEASURES Self-reported weekly working hours, proportions with hours above the limitations of EWTD defined as >48 hours/week and time spent on direct patient care. ANALYSES Linear mixed models with estimated marginal means and proportions. RESULTS From 2016 to 2019, the weekly working hours increased significantly for male general practitioners (GPs) (48.7 hours to 50.9 hours) and male hospital doctors in leading positions (48.2 hours to 50.5 hours), and significantly decreased for female specialists in private practice (48.6 hours to 44.9 hours). The proportion of time spent on direct patient care was noted to be similar between genders and over time. In 2019, it was higher for specialists in private practice (66.4%) and GPs (65.5%) than for doctors in other positions, such as senior hospital consultants (43.5%), specialty registrars (39.8%) and hospital doctors in leading positions (34.3%). Working >48 hours/week increased significantly for both male and female GPs (m: 45.2% to 57.7%; f: 27.8% to 47.0%) and hospital doctors in leading positions (m: 34.4% to 57.1%; f: 17.4% to 46.4%), while it significantly decreased for female specialty registrars (13.2% to 6.9%). CONCLUSIONS Working hours increased significantly for GPs and hospital doctors in leading positions from 2016 to 2019, resulting in increased proportions of doctors with work hours above the EWTD. As work hours above the EWTD can be harmful for health personnel and for safety at work, initiatives to reduce long working weeks are needed.
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Affiliation(s)
- Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
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Gowda S, Simmons J, Gokani VJ. International cross-sectional survey on the use of webinars in plastic surgery: a move towards a hybrid educational model. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021; 45:169-176. [PMID: 34366569 PMCID: PMC8326023 DOI: 10.1007/s00238-021-01849-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022]
Abstract
Background The novel coronavirus pandemic (COVID-19) has catalyzed the development of online educational resources. Webinars provide opportunities for convenient distance-learning and provision of expert lectures, while reducing the financial and practical costs of attending conferences. This cross-sectional survey aims to collect subjective opinion on the usefulness of webinars as an educational platform compared to face-to-face interactions, and whether surgeons and surgeons-in-training want webinars to remain a permanent platform for training and development in the future. Methods A free-to-attend online series of international expert lectures on a range of plastic surgery topics was delivered. Attendees were invited to anonymously complete a survey on attitudes towards webinars as an educational platform over a 2-week period. Results A total of 883 complete responses were collected. Overall webinar attendance increased following the pandemic, with 97.4% of respondents reporting they view webinars for at least 1 h per week following implementation of COVID-19 restrictions. 90.4% respondents indicated that they intend to continue utilizing webinars even once COVID-19 restrictions are eased, and 77.8% stated they learn as much from online webinars as in-person lectures. However, irrespective of training grade, a significant proportion of respondents believe webinars should not replace face-to-face meetings. Conclusions This study provides evidence that, while face-to-face meetings remain a valued component of education in Plastic Surgery, webinars are a useful adjunct to conventional methods, and may feature more prominently in the educational landscape of the future.Level of evidence: Not gradable.
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Affiliation(s)
- Siri Gowda
- Department of Plastic and Reconstructive Surgery, Imperial College Healthcare NHS Trust, Fulham Palace Rd, London, W6 8RF UK
| | - Jonathan Simmons
- Department of Plastic and Reconstructive Surgery, Imperial College Healthcare NHS Trust, Fulham Palace Rd, London, W6 8RF UK
| | - Vimal J. Gokani
- Department of Plastic and Reconstructive Surgery, Imperial College Healthcare NHS Trust, Fulham Palace Rd, London, W6 8RF UK
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Mukherjee S, Meacock J, Kissane E, Pal D. Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade. Br J Hosp Med (Lond) 2021; 82:1-10. [PMID: 33792379 DOI: 10.12968/hmed.2020.0355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or 'being a doctor'. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.
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Affiliation(s)
- Soumya Mukherjee
- Academic Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - James Meacock
- Academic Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - Eleanor Kissane
- Academic Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
| | - Debasish Pal
- Academic Department of Neurosurgery, Leeds General Infirmary, Leeds, UK
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Collins A, Beauregard A. The effect of breaches of the psychological contract on the job satisfaction and wellbeing of doctors in Ireland: a quantitative study. HUMAN RESOURCES FOR HEALTH 2020; 18:89. [PMID: 33183316 PMCID: PMC7661152 DOI: 10.1186/s12960-020-00534-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medicine is one of the most popular college degrees at both undergraduate and postgraduate level. Despite this, morale and wellbeing in doctors at all levels internationally is reportedly low. Long hours and stressful working environments have been implicated as the cause of this. The psychological contract is the implicit expectations and mutual obligations held between an employee and employer. Breaches in this contract can lead to strong negative emotional responses. This study will examine the psychological contract of non-consultant doctors and gain further insight into their job satisfaction and wellbeing. It aims to ascertain the effect of breaches of the psychological contract on their job satisfaction and wellbeing. METHODS This is a quantitative study performed using a questionnaire on a closed online forum. Job satisfaction, wellbeing and breaches of the psychological contract were measured using pre-existing and pre-validated scales. Statistical analysis was performed to determine the effect of breaches of the psychological contract on job satisfaction and wellbeing. RESULTS This study ascertained that training and career development were the most important areas of the psychological contract for non-consultant doctors and training and organizational support the most important breaches. It found, overall, positive levels of job satisfaction and wellbeing. A statistically significant relationship between breaches of the psychological contract and job satisfaction and wellbeing was found. CONCLUSION This study provides an insight into the psychological contract of non-consultant doctors in Ireland. By doing so, it identifies areas for change which may improve their future job satisfaction and wellbeing.
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Affiliation(s)
- Aedin Collins
- Birkbeck, University of London, Malet St, Bloomsbury, London, WC1E 7HX, UK.
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Chang RE, Yu TH, Shih CL. The number and composition of work hours for attending physicians in Taiwan. Sci Rep 2020; 10:14934. [PMID: 32913272 PMCID: PMC7483534 DOI: 10.1038/s41598-020-71873-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022] Open
Abstract
Long work hours among physicians is a worldwide issue in the healthcare arena. Previous studies have largely focused on the work hours of resident physicians rather than those of attending physicians. The purpose of this study was to investigate total work hours and the composition of those work hours for attending physicians across different hospital settings and across different medical specialties through a nationwide survey. This included examining differences in physician workload and its composition with respect to different hospital characteristics, and grouping medical specialties according to the work similarities. A cross-sectional self-reported nationwide survey was conducted from June to September of 2018, and the two questionnaires were distributed to all accredited hospitals in Taiwan. The number of physician work hours in different types of duty shifts were answered by medical specialty in each surveyed hospital. Each medical specialty in a hospital filled only one response for its attending physicians. The findings reveal that the average total work hours per week of an attending physician is around 69.1 h, but the total work hours and their composition of different duty shifts varied among hospital accreditation levels, geographic locations, emergency care responsibilities, and medical specialties. Because of the variance in the number and composition of attending physicians' work hours, adjusting physician work hours to a reasonable level will be a major challenge for health authority and hospital managers.
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Affiliation(s)
- Ray-E Chang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. .,Institute of Health Policy and Management, National Taiwan University, Room 639, No 17, Hsu-Chow Road, Taipei, 100, Taiwan.
| | - Tsung-Hsien Yu
- Department of Health Care Management, National Taipei University of Nursing and Science, Taipei, Taiwan
| | - Chung-Liang Shih
- Department of Medical Affairs, Ministry of Health and Welfare, Taipei, Taiwan
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Shegafi MB, Nashef S, Starodub R, Lee G. Two decades on - cardiothoracic surgical care practitioners in the UK: a narrative review. J Cardiothorac Surg 2020; 15:39. [PMID: 32087704 PMCID: PMC7036233 DOI: 10.1186/s13019-020-1089-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
Background The role of Surgical Care Practitioner (SCP) was first introduced by the NHS in the field of cardiothoracic surgery more than two decades ago to overcome the chronic shortage of junior doctors, and subsequently evolved into other surgical specialties. This review aims to provide evidence on the current situation of SCPs’ clinical outcomes within their surgical extended role, with an emphasis on the cardiothoracic surgical field. Method A systematic search of PubMed, Scopus, Embase via Ovid, Web of Science and TRIP was conducted with no time restriction to explore the evidence on SCPs. All included articles were reviewed by three researchers using the selection criteria, and a narrative synthesis was undertaken. Findings Ten out of the 38 studies identified were selected for inclusion. Only one study specifically investigated cardiothoracic SCPs. Three themes were identified: (1) clinical outcomes (six studies), (2) workforce impact (two studies) and (3) colleagues’ opinions (two studies). All studies demonstrated that SCPs provided safe practice, added value and were of benefit to workforce environments and surgical teams. Conclusion Although the current literature provides assurances that the presence of SCPs within surgical teams is beneficial in terms of their clinical outcomes, their impact on the workforce and colleagues’ opinions, a significant gap was identified around the SCPs’ role within their surgical extended role, specifically in cardiac surgery. Thus, prospective clinical research is required to evaluate SCPs’ clinical impact.
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Affiliation(s)
- Mohammed Bahran Shegafi
- Kings College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK. .,King Abdullah Medical city, Makkah, Saudi Arabia.
| | - Samer Nashef
- Papworth Hospital, Papworth Road, Cambridge Biomedical Campus, Cambridge, CB2 0AY, UK
| | - Roksolana Starodub
- Kings College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
| | - Gerry Lee
- Kings College London, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
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Campaner GRM. The presence of a Surgical Care Practitioner in the perioperative team is of benefit both to the patient and the consultant-led extended surgical team. J Perioper Pract 2019; 29:81-86. [PMID: 29726804 DOI: 10.1177/1750458918764520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Non-medically qualified professionals have progressively advanced and developed in line with the country's constantly evolving health care system. Recently, increasing hospital activity, underfunding in health care and a falling number of doctors have left the NHS perpetually underdoctored, underfunded and overstretched. As the current health care climate demands these 'non-doctors' to demonstrate competent knowledge and skill in providing safe and effective care, this paper discusses limitations, the scope of practice as well as the benefits the Surgical Care Practitioner provides to the modern extended surgical team, and most importantly - the patients under their care.
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Conway R, Byrne D, Cournane S, O’Riordan D, Silke B. Fifteen-year outcomes of an acute medical admission unit. Ir J Med Sci 2018; 187:1097-1105. [DOI: 10.1007/s11845-018-1789-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/09/2018] [Indexed: 11/24/2022]
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Schmit Jongbloed LJ, Cohen-Schotanus J, Borleffs JCC, Stewart RE, Schönrock-Adema J. Physician job satisfaction related to actual and preferred job size. BMC MEDICAL EDUCATION 2017; 17:86. [PMID: 28494758 PMCID: PMC5425993 DOI: 10.1186/s12909-017-0911-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Job satisfaction is essential for physicians' well-being and patient care. The work ethic of long days and hard work that has been advocated for decades is acknowledged as a threat for physicians' job satisfaction, well-being, and patient safety. Our aim was to determine the actual and preferred job size of physicians and to investigate how these and the differences between them influence physicians' job satisfaction. METHOD Data were retrieved from a larger, longitudinal study among physicians starting medical training at Groningen University in 1982/83/92/93 (N = 597). Data from 506 participants (85%) were available for this study. We used regression analysis to investigate the influence of job size on physicians' job satisfaction (13 aspects) and ANOVA to examine differences in job satisfaction between physicians wishing to retain, reduce or increase job size. RESULTS The majority of the respondents (57%) had an actual job size less than 1.0 FTE. More than 80% of all respondents preferred not to work full-time in the future. Respondents' average actual and preferred job sizes were .85 FTE and .81 FTE, respectively. On average, respondents who wished to work less (35% of respondents) preferred a job size reduction of 0.18 FTE and those who wished to work more (12%) preferred an increase in job size of 0.16 FTE. Job size influenced satisfaction with balance work-private hours most (β = -.351). Physicians who preferred larger job sizes were - compared to the other groups of physicians - least satisfied with professional accomplishments. CONCLUSIONS A considerable group of physicians reported a gap between actual and preferred job size. Realizing physicians' preferences as to job size will hardly affect total workforce, but may greatly benefit individual physicians as well as their patients and society. Therefore, it seems time for a shift in work ethic.
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Affiliation(s)
- Lodewijk J. Schmit Jongbloed
- Schmit Jongbloed Advies, Hofbrouckerlaan 30, 2341 LP Oegstgeest, The Netherlands
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Janke Cohen-Schotanus
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Jan C. C. Borleffs
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Roy E. Stewart
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Johanna Schönrock-Adema
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
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Adherence to European Union health and safety legislation requires that the minimum length of nursing programmes leading to registration should be increased. Int J Nurs Stud 2017; 69:A1-A3. [DOI: 10.1016/j.ijnurstu.2017.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abraham J, Whiteman B, Coad J, Kneafsey R. Development and implementation of non-medical practitioners in acute care. ACTA ACUST UNITED AC 2016; 25:1129-1134. [DOI: 10.12968/bjon.2016.25.20.1129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jenny Abraham
- Lead Advanced Clinical Practitioner–Surgical Care Practitioner, University Hospitals Coventry and Warwickshire NHS Trust
| | - Becky Whiteman
- Clinical Research Fellow, Centre for Technology Enabled Health Research, Coventry University
| | - Jane Coad
- Associate Dean of Research and Professor in Children and Family Nursing Coventry University
| | - Rosie Kneafsey
- Head of School of Nursing, Midwifery and Health, Coventry University
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14
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Salpigktidis II, Paliouras D, Gogakos AS, Rallis T, Schizas NC, Chatzinikolaou F, Niakas D, Sarafis P, Bamidis P, Lazopoulos A, Triadafyllidou S, Zarogoulidis P, Barbetakis N. Burnout syndrome and job satisfaction in Greek residents: exploring differences between trainees inside and outside the country. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:444. [PMID: 27999778 DOI: 10.21037/atm.2016.11.33] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The purpose of this study is to investigate the levels of burnout among Greek residents, highlighting potential differences between those practicing at home and abroad, as well as to investigate correlations with demographic, individual and labor factors. METHODS The research was conducted on a sample of 131 residents, using an anonymous questionnaire which included demographic, individual and labor characteristics, Maslach's Burnout Inventory, questions regarding job and life satisfaction levels, working conditions and the impacts of the economic recession. RESULTS Fifty two point seven percent of the sample were training in the Greek National Health Service (N.H.S.), 27.5% in Germany and 19.8% in the United Kingdom. One out of three residents in the Greek system showed high levels of burnout in all three dimensions of the syndrome, while 51.1%, 72.2% and 30.8% of the Greek, British and German team, respectively, appeared burnt out simultaneously in two dimensions. Levels of job and life satisfactions ranged on average, while workload appeared heavy. CONCLUSIONS The occurrence of burnout was associated with gender, specialty, employment characteristics (working hours, autonomy, support etc.), proneness to accidents, country, job satisfaction and quality of life, but was not associated with age or marital status. No correlation was found with susceptibility to medical errors.
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Affiliation(s)
| | - Dimitrios Paliouras
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece; ; Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Apostolos S Gogakos
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Thomas Rallis
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Nikolaos C Schizas
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Fotios Chatzinikolaou
- Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Niakas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
| | - Pavlos Sarafis
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece; ; Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Panagiotis Bamidis
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece; ; Department of Medical Physics, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece
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15
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Brohan J, Moore D. EWTD compliance amongst Anaesthesia trainees in Ireland. Ir J Med Sci 2016; 186:41-48. [DOI: 10.1007/s11845-016-1450-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 03/18/2016] [Indexed: 10/22/2022]
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16
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Plastic Surgery Training Worldwide: Part 1. The United States and Europe. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e641. [PMID: 27257571 PMCID: PMC4874285 DOI: 10.1097/gox.0000000000000627] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 01/21/2016] [Indexed: 12/20/2022]
Abstract
Background: Major differences exist in residency training, and the structure and quality of residency programs differ between different countries and teaching centers. It is of vital importance that a better understanding of the similarities and differences in plastic surgery training be ascertained as a means of initiating constructive discussion and commentary among training programs worldwide. In this study, the authors provide an overview of plastic surgery training in the United States and Europe. Methods: A survey was sent to select surgeons in 10 European countries that were deemed to be regular contributors to the plastic surgery literature. The questions focused on pathway to plastic surgery residency, length of training, required pretraining experience, training scheme, research opportunities, and examinations during and after plastic surgery residency. Results: Plastic surgery residency training programs in the United States differ from the various (selected) countries in Europe and are described in detail. Conclusions: Plastic surgery education is vastly different between the United States and Europe, and even within Europe, training programs remain heterogeneous. Standardization of curricula across the different countries would improve the interaction of different centers and facilitate the exchange of vital information for quality control and future improvements. The unique characteristics of the various training programs potentially provide a basis from which to learn and to gain from one another.
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Lambert TW, Smith F, Goldacre MJ. The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013-2014. JRSM Open 2016; 7:2054270416632703. [PMID: 26981257 PMCID: PMC4776251 DOI: 10.1177/2054270416632703] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives To report doctors’ views about the European Working Time Directive (‘the Directive’). Design Survey of the medical graduates of 2002 (surveyed in 2013–2014). Participants Medical graduates. Setting UK. Main outcome measures Questions on views about the Directive. Results The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work–life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors’ training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Conclusions Senior doctors agreed that the Directive benefited doctors’ work–life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.
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Affiliation(s)
- Trevor W Lambert
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX7 3LF, UK
| | - Fay Smith
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX7 3LF, UK
| | - Michael J Goldacre
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX7 3LF, UK
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Humphries N, McAleese S, Matthews A, Brugha R. 'Emigration is a matter of self-preservation. The working conditions . . . are killing us slowly': qualitative insights into health professional emigration from Ireland. HUMAN RESOURCES FOR HEALTH 2015; 13:35. [PMID: 25981629 PMCID: PMC4437248 DOI: 10.1186/s12960-015-0022-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 04/24/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Achieving a sustainable health workforce involves training and retaining sufficient staff to deliver health services. The Irish health workforce is characterised by a high level of emigration of Irish-trained staff and a heavy reliance on internationally trained staff. This paper presents qualitative findings from a mixed-method study of doctors, nurses and midwives who have recently emigrated from Ireland. METHODS Using Facebook, this study elicited 556 (388 completed) responses to an exploratory mixed-method online survey in July 2014. Respondents provided rich responses to two free-text questions, one on health worker return (N = 343) and another on health professional emigration (N = 209) from the source country (Ireland). RESULTS Respondents emigrated because of difficult working conditions in the Irish health system (long working hours, uncertain career progression), which compared poorly with conditions in the destination country. Respondents' experiences in the destination country vindicated the decision to emigrate and complicated the decision to return. Their return to Ireland was contingent upon significant reform of the Irish health system and an improvement in working conditions, expressed, for example, as: 'It's not about the money, it's about respect . . . we love working in medicine, but we love our families and health more' (RD283). CONCLUSIONS This paper highlights that doctors, nurses and midwives are emigrating from Ireland in search of better working conditions, clear career progression pathways and a better practice environment. The question for the source country is whether it can retain and attract back emigrant doctors, nurses and midwives by matching their expectations.
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Affiliation(s)
- Niamh Humphries
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, RCSI, 123 St. Stephen's Green, Dublin 2, Dublin, Ireland.
| | - Sara McAleese
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, RCSI, 123 St. Stephen's Green, Dublin 2, Dublin, Ireland.
| | - Anne Matthews
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
| | - Ruairi Brugha
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, RCSI, 123 St. Stephen's Green, Dublin 2, Dublin, Ireland.
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