Clinical and education implications of shift work

Abstract

Yorkshire teaching hospital staffs' perceptions before and after implementing a junior doctor shift system are reported. The study is placed in context by discussing the European Working Time Directive and the New Deal for Doctors. Five education and clinical issues are examined using data from activity diaries and attitude questionnaires. Interesting findings emerge that sometimes contradict the literature. Important recommendations are made to ease the NHS's inevitable move towards shift work.

The effect of the EWTD on training in general surgery: an analysis of electronic logbook records

“…This disruption of the diurnal rhythm runs counter to the ethic of the EWTD to protect the trainees' quality of life but quite apart from the disturbance of sleep patterns, 22 shift working has tended to break up the clinical team and to reduce the frequency of training and teaching opportunities. 30,31 The move to a 48-hour week in 2009 can only exacerbate the threat to training in a specialty where even off-site teaching sessions are included in the calculation of hours spent at work.…”

The training/service continuum: exploring the training/service balance of senior house officer activities

“…Given this lack of direction, it is not surprising that research results on the impacts of shift‐working and reduced hours on junior doctor training are inconclusive and contradictory 15 . Some studies comparing shift‐working with on‐call patterns have found significantly lower training experience and training satisfaction scores for participants, 16,17 while others purport that training standards are maintained 18 or even improved due to better learning and working conditions associated with less tiredness. The literature also refers to adverse impacts on training in relation to loss of continuity of care, 6 and claims that when hours are reduced, there are fewer opportunities for learning, 17,19 experience is diluted 20 and service takes precedence over training 16,21 .…”