TY - JOUR

T1 - The perceived effects of the European working time directive upon training opportunities for specialist registrars in general surgery in the West Midlands

AU - Padwick, R.

AU - Markham, D.

AU - Johnson, N.

PY - 2013/8

Y1 - 2013/8

N2 - Background: There is concern in the medical literature that reduced workhours as a result of the European Working Time Directive (EWTD) isdetrimental to surgical training due to reduction in workplace-based trainingopportunities. This is supported by literature suggesting that learning theoriesapplicable to surgical training include social learning and constructivism, andthat surgeons are ‘hands-on’, practical learners. However, there is no conclusiveevidence that reduced hours is detrimental to surgical training, and this studyaims to explore whether this is indeed the case.Methods: A series of one-to-one semi-structured interviews were performedwith Year 5 and 6 Specialist Registrars in General Surgery on the West MidlandsHigher Surgical Training scheme. Nine interviews were performed beforethematic saturation was reached. Interview transcripts were then thematicallyanalysed in NVivo 9.Results: Participants perceive the EWTD to have reduced trainingopportunities due to reduced hours, a change to working shifts as opposedto 24-hour on-calls and the introduction of timetabled days off into on-callrotas in order to make them EWTD-compliant, which is largely being usedin order to gain further training opportunities. Trainees are attending coursesand going on Fellowships in order to augment training. There is a difference inopinion as to what constitutes training and what constitutes service provision.Trainees perceive that shift-working leads to increased fatigue and a disruptionto life outside of work.Conclusion: Overall perceptions are of a detrimental effect upon trainingopportunities for a variety of reasons, which is consistent with the currentliterature. New theory has been generated regarding the perceptions of serviceand training activities, and the differences between 24-hour on-calls and shiftsupon fatigue, which could be explored further with quantitative methodologies.

AB - Background: There is concern in the medical literature that reduced workhours as a result of the European Working Time Directive (EWTD) isdetrimental to surgical training due to reduction in workplace-based trainingopportunities. This is supported by literature suggesting that learning theoriesapplicable to surgical training include social learning and constructivism, andthat surgeons are ‘hands-on’, practical learners. However, there is no conclusiveevidence that reduced hours is detrimental to surgical training, and this studyaims to explore whether this is indeed the case.Methods: A series of one-to-one semi-structured interviews were performedwith Year 5 and 6 Specialist Registrars in General Surgery on the West MidlandsHigher Surgical Training scheme. Nine interviews were performed beforethematic saturation was reached. Interview transcripts were then thematicallyanalysed in NVivo 9.Results: Participants perceive the EWTD to have reduced trainingopportunities due to reduced hours, a change to working shifts as opposedto 24-hour on-calls and the introduction of timetabled days off into on-callrotas in order to make them EWTD-compliant, which is largely being usedin order to gain further training opportunities. Trainees are attending coursesand going on Fellowships in order to augment training. There is a difference inopinion as to what constitutes training and what constitutes service provision.Trainees perceive that shift-working leads to increased fatigue and a disruptionto life outside of work.Conclusion: Overall perceptions are of a detrimental effect upon trainingopportunities for a variety of reasons, which is consistent with the currentliterature. New theory has been generated regarding the perceptions of serviceand training activities, and the differences between 24-hour on-calls and shiftsupon fatigue, which could be explored further with quantitative methodologies.

U2 - 10.1002/bjs.9239

DO - 10.1002/bjs.9239

M3 - Meeting abstract

VL - 100

SP - 152

EP - 152

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - Suppl. 7

T2 - International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI)

Y2 - 1 May 2013 through 3 May 2013

ER -