Accepted Type
Oral
Code
OA3-1-1
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
no
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Resident
Affiliation
Considered for Poster
yes
Title
A Signal: Resident Perspectives on Decision-Making Processes and Impacts of Back-up Call Activations in an Internal Medicine Residency Program
Length of Presentation
Background/Purpose
Residency programs rely on jeopardy or back-up call systems to address gaps in coverage when a resident cannot complete their call shift. Residents' perceptions on underlying motivations for activating back-up, and how these decisions vary by context, remain unknown. The authors explored residents' reasons for call activations and impacts of the back-up call system on education and burnout.
Methods
Eighteen semi-structured one-on-one interviews were conducted from September 2019 to February 2020 with internal medicine and chief medical residents from the University of Toronto. Interviews explored participants' experiences and perceptions with call activations. A constructivist grounded theory approach was used to develop a conceptual understanding of the back-up system as it relates to residents' decisions underlying activations, downstream impacts and relationships to burnout.
Results
Residents described a complex thought process when deciding whether to activate. Decisions were coloured by inner conflicts including sense of collegiality, need to maintain an image, and time of year balanced against self-reported burnout. Residents described how back-up models can inherently perpetuate burnout, lowering thresholds to trigger activations. Impacts included anxiety of not knowing whether an activation would occur, decreased educational productivity from exhaustion and the "domino effect" of increased workload for colleagues.
Conclusion
Residents weigh inner tensions when deciding to activate back-up. Their collective experience suggests that burnout is both a trigger and consequence of back-up call activations, creating a cyclical relationship. Escalating rates of call activations may signal that burnout amongst residents is high, warranting further exploration from educational leads.
Keyword 1
Backup call
Keyword 2
Resident wellness
Keyword 3
Professionalism
Level of Training
Post Graduate
Abstract Themes
Postgraduate
Additional Theme (First choice)
Professionalism
Additional Theme (Second Choice)
Physician & Medical Student Health and Well-being
Additional Theme (Third Choice)
Authors
Presenter
Natasha Sheikh
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
