Testable Hypothesis. That Residents Spend Less Time

¶ … testable hypothesis.

That residents spend less time teaching ever since promulgation of Duty-Hour Restrictions (DHR) and that this impacts their well-being and perception of patient-care.

Question 2 What research subjects or data sources did the researchers use in the study? 164 residents in internal medicine in UCSF. A survey was used that was first tested in a pilot study on noninternal medicine house-staff at the medical center and recent graduates of residency programs as well as reviewed by experts in medical education, outcomes research, and psychometrics. Researchers also used 'emotional exhaustion' scale to assess participants' level of exhaustion with their work.

Question 3 What are the specific variables of interest, as well as the possible confounds and covariates the researcher should consider? What are the data types and levels of these variables?

The specific variables of interest were the amount of time residents spent teaching before February 2003 compared to the amount of time residents spent teaching after that period. Data types were nominal and constituted age (30 years and beyond); sex; postgraduate year; and training program (primary care, categorical, or preliminary). The later was 3 levels.

Question 4 What statistical tests were used? Were they inferential or correlational? Were they parametric or non-parametric? Give the specific names of these tests.

All tests were parametric. The statistical tests were descriptive and inferential. Univariate statistics were used to assess distribution and frequency of response. These were descriptive. Bivariate (inferential) were correlation analyses (multivariate logistic regression as well as linear regression model) and t-tests (to assess comparison between the two groups and test for association).

Question 5 How are the results of the statistical analysis shown to be statistically and/or practically significant, or not significant? What was the p value mentioned Twenty-four (24.2%) residents reported spending less (n = 21) or much less (n = 3) time teaching after DHR began.

Multivariate models showed that working more than 80 hours and increased time on administrative tasks resulted in less teaching time. Bivariate comparisons (comparisons between the two variables) showed that residents who reported reduced teaching time were less emotionally exhausted (P = 0.006)

and more satisfied with the patient care they provided (P = 0.003). In short, researchers found that approximately 25% reported less time teaching since DHR. This was a significant result

Reference

Mazzotti, L., Vidyahrti, A., Wachter, R., Auerbach, A., & Katz, P. (2009) Impact of Duty-Hour Restriction on Resident Inpatient Teaching, Journal of Hospital Medicine, 4, 476-480

Question 1 State the articles research hypothesis. If the article doesn't do this, or doesn't do it clearly, state what you believe is the testable hypothesis.

1. The authors' hypotheses was that a simulation-based educational program would improve the resident's Advanced Cardiac Life Support (ACLS) skills; and that the resident needed periodic training for improvement.

Question 2 What research subjects or data sources did the researchers use in the study?

2 nd-year residents from Chicago's Northwestern University's internal medicine residency program. 38 students. They received four 2-hour practice-training sessions in simulator intervention and ACLS skills, and practiced on a computerized dummy.

Question 3 What are the specific variables of interest, as well as the possible confounds and covariates the researcher should consider? What are the data types and levels of these variables?

The independent variable was the simulated-based educational program with practical component. The dependent variable was the resident's skill level and improvement in ACLS. This was measured by three tests including one at the outset to assess initial skills.

Covariates were nominal data and included demographics such as age, gender, ethnicity, medical school, and scores on the United States Medical Licensing Examination. Gender was 2 levels; Ethnicity - 5 levels; and ACLS situations that residents experienced during their first year of training was 4 levels (0-5; 5-10; 10-15; 15+). Confounds include the fact that the dummy was used for education and testing and the fact that testing and training were both applied only to one sample, that was not only small but also relatively non-diversified.

Question 4 What statistical tests were used? Were they inferential or correlational? Were they parametric or non-parametric? Give the specific names of these tests.