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Changes in residents’ opportunities for experiential learning over time

Authors

  • Adam D Peets,

    1. Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
    2. Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada
    3. Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
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  • Henry T Stelfox

    1. Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
    2. Department of Medicine, University of Calgary, Calgary, Alberta, Canada
    3. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Dr Henry T Stelfox, Department of Critical Care Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. Tel: 00 1 403 944 2334; Fax: 00 1 403 283 9994; E-mail: tstelfox@ucalgary.ca

Abstract

Medical Education 2012: 46: 1189–1193

Context  Learning in the clinical environment is believed to be a crucial component of residency training. However, it remains unclear whether recent changes to postgraduate medical education, including the implementation of work hour limitations, have significantly impacted opportunities for experiential learning. Therefore, we sought to quantify opportunities to gain clinical experience within medical-surgical intensive care units (ICUs) over time.

Methods  Data on the numbers of patients admitted and invasive procedures performed per day between 1 July 2001 and 30 June 2010 within three academic medical-surgical ICUs in Calgary, Alberta, Canada were obtained from electronic medical records. These data were matched to resident doctor on-call schedules and residents’ opportunities to admit patients and participate in procedures were calculated and compared over time using Spearman’s rho.

Results  We found that over a 9-year period, the opportunities afforded to residents (n = 1156) to admit patients (n = 17 189) and perform procedures (n = 52 827) during ICU rotations decreased by 32% (p < 0.001) and 34% (p < 0.001), respectively.

Conclusions  Our results suggest that there has been a significant decrease in residents’ clinical experiences in the ICU over time. Further investigations to better understand these changes and how they may impact on performance as residents become independent practising doctors are warranted.

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