Pediatric residents' and continuity clinic preceptors' perceptions of the effects of restricted work hours on their learning relationship

Dorene Balmer, Sheryl Ruzek, Stephen Ludwig, Angelo Giardino
Ambulatory Pediatrics: the Official Journal of the Ambulatory Pediatric Association 2007, 7 (5): 348-53

OBJECTIVE: The effects of the Work Hour Standard (WHS) on continuity of care and quality of education has stimulated much discussion, yet little is known about how it affects the resident-continuity clinic preceptor (CCP) dyad, the only longitudinal learning relationship in pediatric residency. This case study explored residents' and CCPs' perceptions of the effects of restricted work hours on their learning relationship.

METHODS: Direct observation of third-year pediatric residents (n = 10) and their CCPs (n = 10) was carried out in continuity clinic (CC) for 5 months; both groups attended clinic before and after the WHS. Semistructured, audiotaped interviews were conducted with residents before and after observation, and with CCPs after resident data were collected. Data from interview transcripts and observational notes were analyzed for major themes.

RESULTS: To comply with the WHS, postcall clinic was eliminated and residents were rescheduled to another afternoon CC. The consequence of eliminating postcall clinic, disruption in the resident-CCP relationship, was perceived differently by residents and CCPs. From the residents' perspective, rescheduling CC in response to the WHS benefited their learning because it exposed them to different CCPs with different practice styles. From the CCPs' perspective, rescheduling CC frustrated their efforts to be learner-centered teachers and effective mentors.

CONCLUSIONS: Intended changes to limit excessive work hours had unintended effects that were viewed more favorably by residents than by CCPs. Understanding the shared and different perspectives of residents and preceptors regarding WHS-related changes in CC extends the discussion of the effect of restricted work hours.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"