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Background: The success of a clinical trial depends on its recruitment of eligible patients; therefore, the recruitment period requires special attention. We hypothesized that with a new approach focused on continuous information and gratification, resident motivation to participate in scientific work will increase and recruitment rates will improve.Methods: Our new recruitment approach was applied to the recruitment phase of two prospective randomized trials (registered at the German Clinical Trials Register). Randomization of these trials was performed first using blinded envelopes; later a soft drink machine was used as the delivery tool of randomization as a lighthearted motivation to join scientific work and to reward the resident with free soft drinks for each recruitment. Residents were informed about the trial via a lecture and by mail. To increase interest everyone received Swiss chocolate. With a multiple choice survey we investigated the success of our actions at 6 and 12 months. Recruitment rates of the trials were evaluated and associated with the motivational approaches.Results: Our residents rated their awareness of the trials with median 9 (IQR 7;9) during the first and 8 (IQR 5;9) during the second survey and their interest in scientific work with median 7 (IQR 4;8) and 6 (IQR 5;8). The percentage of residents feeling highly motivated improved from 58% to 70%. The recruitment rates stayed stably high over time with 73% and 72% in trial 1 and 90% and 85% in trial 2; 24% of residents stated their motivation could be increased by gratifications.Conclusions: After implementation of our new recruitment approach we found positively motivated residents and high recruitment rates in the corresponding trials. We propose this procedure may help to ensure the successful initiation of clinical trials. Larger studies testing this approach are warranted. [ABSTRACT FROM AUTHOR]

Background: Within Emergency Department (ED), problem responsiveness and organizational capacity are extremely important for providing acute care. The "July effect" has been described as the period when junior doctors start new turnovers, possibly reflecting on hospital and ED efficiency. The objective of this study was to investigate the impact of residents' turnover on ED efficiency at a Swiss teaching hospital. Methods: We retrospectively evaluated patients presenting with surgical needs to ED from June 2014 to January 2019. Data regarding gender, age, length of stay (LOS), resident doctors and level of urgency were collected and analyzed. Results: We identified 27,767 surgical admissions treated by 92 residents. The LOS analysis within residents' period in the ED showed a progressive reduction over time, with 80% of proficiency achieved after 98 patients. The mean LOS was 257.3 and 237.6 min during and after the learning curve (p < 0.0001), although no difference was noted in triage level 1 patients (p = 0.813). By replacing 40–70% of residents (January and July), the LOS raised from 243.1 to 259.7 min (absolute difference 16.6 min, p < 0.001), but if only 10–20% of residents newly started, no difference was detected (p = 0.071). Conclusions: Our study demonstrates that surgical residents' turnover within the ED could affect the overall efficiency. The training period for new resident physicians was a caseload of 98 patients, respectively, 3 weeks of work. The impact of trainees' turnover was only relevant if more than 40% of the resident team is replaced at one time and only less urgent cases were affected. [ABSTRACT FROM AUTHOR]