Pediatric residents' perceptions of the impact of the 24-hour on-call system on their well-being and education and patient safety A national survey

Objectives: To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. Methods: A cross-sectional survey conducted with residents enrolled in pediatric residency programs across Saudi Arabia in February 2017 at the Saudi Commission For Health Specialties, Riyadh Saudi Arabia. We designed a self-administered questionnaire that was distributed using the Saudi Commission for Health Specialties E-mail groups. A 4-point Likert-type scale was used to rank the residents' responses; and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. Results: A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%). Conclusion: We found that the 24-hour on-call system negatively impacts residents' well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.