3 results on '"Russell Dumire"'
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2. Professionalism in the Twilight Zone
- Author
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Mohsen Shabahang, David C. Borgstrom, Johnathan Fryer, Randy J. Woods, James E. Coverdill, M. Timothy Nelson, Steven B. Holsten, Adnan Alseidi, Paula M. Termuhlen, Thomas H. Hartranft, Daniel L. Dent, Stanley R. Sherman, Russell Dumire, and John D. Mellinger
- Subjects
Students, Medical ,Medical psychology ,020205 medical informatics ,Duty hours ,education ,Staffing ,Workload ,02 engineering and technology ,Education ,Shift work ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Work Schedule Tolerance ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Medicine ,030212 general & internal medicine ,Response rate (survey) ,Medical education ,business.industry ,Transition (fiction) ,Patient Handoff ,Internship and Residency ,General Medicine ,United States ,Professionalism ,Work (electrical) ,Education, Medical, Graduate ,Dynamics (music) ,General Surgery ,business ,Social psychology - Abstract
Purpose Duty hours rules sparked debates about professionalism. This study explores whether and why general surgery residents delay departures at the end of a day shift in ways consistent with shift work, traditional professionalism, or a new professionalism. Method Questionnaires were administered to categorical residents in 13 general surgery programs in 2014 and 2015. The response rate was 76% (N = 291). The 18 items focused on end-of-shift behaviors and the frequency and source of delayed departures. Follow-up interviews (N = 39) examined motives for delayed departures. The results include means, percentages, and representative quotations from the interviews. Results A minority (33%) agreed that it is routine and acceptable to pass work to night teams, whereas a strong majority (81%) believed that residents exceed work hours in the name of professionalism. Delayed departures were ubiquitous: Only 2 of 291 residents were not delayed for any of 13 reasons during a typical week. The single most common source of delay involved a desire to avoid the appearance of dumping work on fellow residents. In the interviews, residents expressed a strong reluctance to pass work to an on-call resident or night team because of sparse night staffing, patient ownership, an aversion to dumping, and the fear of being seen as inefficient. Conclusions Resident behavior is shaped by organizational and cultural contexts that require attention and reform. The evidence points to the stunted development of a new professionalism, little role for shift-work mentalities, and uneven expression of traditional professionalism in resident behavior.
- Published
- 2016
3. The Resident Experience on Trauma: Declining Surgical Opportunities and Career Incentives? Analysis of Data from a Large Multi-institutional Study
- Author
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Ajai K. Malhotra, Antoinette Kanne, Lawrence Lottenberg, Michael F. Rotondo, Richard A. Pomerantz, Andrew B. Peitzman, Scott G. Sagraves, Pascal Udekwu, Juan L. Peschiera, Jennifer L. Sarafin, David J. Dries, Thomas M. Scalea, Gary W. Welch, Kwang I. Suh, Juan A. Asensio, Michael Oswanshi, Farouck N. Obeid, Ronald G. Albuquerque, Victor L. Landry, Hans Joseph Schmidt, Deborah Baker, Dorraine D. Watts, Raymond Talucci, Scott B. Frame, John B. Holcomb, Lewis J. Kaplan, Dennis Wang, S. M. Siram, Grace S. Rozycki, Russell Dumire, Benjamin D. Mosher, Eliza Enriquez, Terrence H. Liu, Samir M. Fakhry, Anne Kuzas, F.Barry Knotts, Sherry M. Melton, John F. Bilello, George M. Testerman, Blaine L. Enderson, James S. Gregory, Dennis W. Ashley, Patrick A. Dietz, Karlene E. Sinclair, Diane Higgins, Ivan Puente, Barbara Esposito, Stuart J.D. Chow, William F. Pfeifer, Daniel C. Cullinane, Judith Phillips, James K. Lukan, Michael Moncure, John L. Hunt, John R. Hall, Susan Schrage, Pauline Park, Faran Bokhari, Jeffery Rosen, Kathleen A. LaVorgna, Gerard J. Fulda, Monica Newton, Macram M. Ayoub, Leanne Adams, Mark L. Gestring, Thomas A. Santora, Paul R. Kemmeter, Joan L. Huffman, William Marx, Mitchell S. Farber, Karyn L. Butler, Collin E.M. Brathwaite, Jon Walsh, Jeffrey P. Salomone, John D. Josephs, Timothy C. Fabian, Frederick A. Moore, Murray J. Cohen, Paul E. Bankey, Wayne E. Vander Kolk, Dan A. Galvan, John Bonadies, Walter Forno, James M. Cross, Nirav Patel, Pam Nichols, Carnell Cooper, Michael Haraschak, Judith A. O'connor, Daniel Powers, Mary B. Myers, Kathleen P. O’hara, A. Jay Raimonde, Hani Seoudi, Juan B. Grau, Imtiaz A. Munshi, Kimberly K. Nagy, Peter Rhee, Eddy H. Carrillo, Sharon Buchro, Mary Jo Wright, Lisa A. Patterson, Dennis B. Dove, C. M. Buechler, Wendy L. Wahl, Wendy Sue Shreve, Thomas H. Cogbill, Robert A. Cherry, Scott H. Norwood, J. Martin Perez, Bernard R. Boulanger, J. P. Dineen, John E. Sutton, Arthur B. Dalton, Scott Monk, Carl P. Valenziano, Christopher D. Wohltmann, Michael Schurr, Robert A. Jubelelirer, William J. Mileski, Tiffany K. Bee, Kathy Coon, Fred A. Luchette, April Settell, Arthur L. Ney, Jonathan Kohn, Mary E. Fallat, Sheila Staib, Dennis C. Gore, Van L. Vallina, Jose A. Acosta, David Kam, Jeff Strickler, Eileen Corcoran, Leon H. Pachter, Anne O'Neill, Lonnie W. Frei, Larry M. Jones, David G. Jacobs, Om P. Sharma, Curt S. Koontz, Christopher P. Michetti, Michael D. Pasquale, Raymond P. Bynoe, Pablo Rodriguez, Robert Marburger, Michael C. Chang, Karla S. Ahrns, Michael D. McGonigal, Paula Griner, Gustavo Roldán, Leonard J. Weireter, Sharon S. Cohen, Andrew J. Kerwin, L. F. Diamelio, Mauricio Lynn, Donald H. Jenkins, John P. Hunt, W. Michael Johnson, Robert Holtzman, Brian J. Daley, Paul Dabrowski, Jeffrey J. Morken, Vicki J. Bennett-Shipman, Stanley Kurek, Charles J. Yowler, Christopher Salvino, Dale Oller, Brian J. Norkiewicz, Vicki Hardwick-Barnes, Don Fishman, Frederic J. Cole, John C. Layke, Frederick B. Rogers, James Davis, Keith D. Clancy, Emily M. Sposato, Judith Johnson, Charles E. Wiles, Uretz J. Oliphant, and James V. Yuschak
- Subjects
medicine.medical_specialty ,Attitude of Health Personnel ,medicine.medical_treatment ,Specialty ,Traumatology ,Critical Care and Intensive Care Medicine ,Patient Admission ,Diagnostic peritoneal lavage ,Blunt ,Trauma Centers ,Surveys and Questionnaires ,Laparotomy ,medicine ,Humans ,Focused assessment with sonography for trauma ,Peritoneal Lavage ,Ultrasonography ,Motivation ,Career Choice ,medicine.diagnostic_test ,business.industry ,General surgery ,Trauma center ,Internship and Residency ,United States ,Education, Medical, Graduate ,Blunt trauma ,Case-Control Studies ,Workforce ,Physical therapy ,Wounds and Injuries ,Surgery ,Clinical Competence ,business - Abstract
Purpose: The surgical resident experience with trauma has changed. Many residents are exposed to predominantly nonoperative patient care experiences while on trauma rotations. Data from a large multicenter study were analyzed to estimate surgical resident exposure to trauma laparotomy, diagnostic peritoneal lavage (DPL), and focused abdominal sonography for trauma (U/S). Methods: Centers completed a self-report questionnaire on their institutional demographics, admissions, and procedure for a 2-year period (1998-1999). Results: A total of 82 trauma centers that provide resident teaching were included. The included centers represent over 247,000 trauma admissions. The majority of trauma centers (65.9%) had > 80% blunt injury. Although all centers performed laparotomies, other results were more variable. For U/S, 24.2% performed none at all and 47.0% performed fewer than two U/S examinations per month. For DPLs, 3.8% performed none and 66.7% performed fewer than two per month. Assuming 1 night of 4 on call, the average surgical resident training at a trauma center performing > 80% blunt trauma has the potential to participate in only 15 trauma laparotomies, 6 diagnostic peritoneal lavages, and 45 ultrasound examinations per year. In addition, the resident will care for an average of 500 blunt trauma patients before performing a splenectomy or liver repair. Conclusion: Surgical resident experience on most trauma services is heavily weighted to nonoperative management, with a relatively low number of procedures, little experience with DPL, and highly variable experience with ultrasound. These data have serious implications for resident training and recruitment into the specialty.
- Published
- 2003
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