Does 24/7 intensivist coverage impact housestaff skills?

(HealthDay)—Pediatric intensivists and housestaff have concerns regarding the preparation of housestaff after being trained in a 24/7 in-house (or in-hospital [IH]) attending model, according to a study published online Dec. 9 in Pediatrics.

Kyle J. Rehder, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues evaluated the effects of increased attending physician presence on education of pediatric housestaff. An anonymous web-based survey was sent to pediatric intensivists in the United States and Canada, as well as pediatric critical care fellows and pediatric residents at academic centers across the United States.

The researchers found that, based on 1,323 responses from 147 institutions, 96 percent of respondents reported that the pediatric intensive care unit provides "a good educational experience." Only 50 percent of pediatric intensivists and 67 percent of housestaff felt that after training in an IH model are housestaff prepared for independent practice. Respondents currently working in IH models have more favorable perceptions of the effects of IH coverage on housestaff autonomy, supervision, and preparation for independent practice (P < 0.0001 for all), compared to those training in home-call models.

"An important priority for institutions using or considering a 24/7 IH attending coverage model is the balance between adequate housestaff supervision and autonomy," the authors write.

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