A National Survey of Motor Vehicle Crashes Among General Surgery Residents

Abstract

Objectives:Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events.Summary of Background Data:MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk.Methods:General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes.Results:Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21–3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53–4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65–3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00–3.24)].Conclusions:Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.

Comment on “A National Survey of Motor Vehicle Crashes Among General Surgical Residents”

“…It was with great interest that we read the study "A National Survey of Motor Vehicle Crashes (MVC) Among General Surgical Residents." 1 In their survey, the authors identified that increases in duty hour violations were associated with an increased in hazardous driving events. The safety and wellbeing of surgical (and all) residents are of paramount importance, and this study clearly identifies a serious issue that has been long known but not widely spoken about.…”

Crash/Near-Crash Analysis of Naturalistic Driving Data Using Association Rule Mining

“…The rules for near-crash events are summarized from three aspects: (1) road: level roads (rules 9, 19, 22, 23, and 24), divided roads (median strip or barrier) (rule 3), roads with 2 to 7 lanes (rules 4, 11, 14, 16, 17, 18, 19, 20, 21, 22, 23, 24, and 25), and straight roads (rules 10, 20) are more likely to be associated with near-crash events. (2) Driver: middle-aged and older (rules 2,5,11,12,13,14,15,16,17,18,19,20,21,22,23,24, and 25) male (rule 13) participants with an estimated average annual mileage over five years of more than 15,000 miles (rules 6, 7, 8, 9, 10, 12, and 15) are more likely to be associated with near-crash events when they are performing secondary tasks (rules 8, 18, 21, and 25). Note that driver impairments (rules 7, 17, 23, 24, and 25), driver behavior (rules 12, 23), or unexpected events (rule 6) are not correlated with near-crash events.…”

“…Kreusslein et al [19] focused on the characteristics of mobile phone calls, including the call duration, glance behavior, call type, and mobile phone location, to determine the influence of making mobile phone calls. Schlick et al [20] used hierarchical regression models to determine the associations between motor vehicle crashes and different contributing factors.…”