1. ACGME Resident Survey Prep
ACGME Resident Survey: New Resource Available
ACGME Resident Survey Prep
Brought to you by APDIM Council
January 2019

2. the purpose of the survey
ACGME Resident Survey: New Resource Available
the purpose of the survey
The survey is conducted annually and contains questions about your clinical and educational experiences as well as your learning environment
The data gathered in the survey is confidential and only aggregate program level data is provided by the ACGME to administrators and program directors
The ACGME uses data from the resident survey as one of several tools that help determine program accreditation and to identify any potential problem areas in a program

3. Survey is for your current academic year experience
ACGME Resident Survey: New Resource Available
Survey is for your current academic year experience
The survey is asking you about your experience over the course of the current academic year (from July 1 to June 30)
This includes your experience in the inpatient and outpatient settings, so please consider the entire year in your replies

4. Some terms are confusing...
ACGME Resident Survey: New Resource Available
Some terms are confusing...
In-House Call: In-house call refers to duty hours in addition to the regular resident workday that are spent within an institution so that residents are immediately available, as needed, for clinical duties. In-house call does NOT include night float, being on call from home, or regularly scheduled overnight duties. In-house call refers to resident shifts that approach or exceed 24 hours
The Q3 limit applies to overnight in-house call, not to shorter shifts. The Q3 limit does not apply to a series of night shifts without daytime assignments (which would be a night float rotation)
Night float: Is a rotation designed to eliminate in-house call or assist other residents during the night

5. Some terms are confusing...
ACGME Resident Survey: New Resource Available
Some terms are confusing...
Cross-coverage is the term used to describe coverage of patients that a team member would provide for another resident on their patient care team. For example, if John and Mary are interns on the same team, Mary would provide cross-coverage of John’s patients on Saturday when John has the day off, and John would provide cross-coverage of Mary’s patients on Sunday when Mary has the day off
Assignment is synonymous with a clinical rotation (not a writing or reflective assignment)

6. Education vs. Non-Physician obligations
ACGME Resident Survey: New Resource Available
Education vs. Non-Physician obligations
Education includes providing care for patients in the clinical setting, in addition to didactic and small group teaching sessions
Non-physician obligations: are those duties which in most institutions are performed by nursing and allied health professionals, transport services or clerical staff. It is understood that while residents, like non-resident physicians, may be expected to do any of these things on occasion, these should not be performed routinely by residents and must be kept to a minimum to optimize resident education. Examples:
transport of patients from the wards or units for procedures elsewhere in the hospital
routine blood drawing for lab tests
routine monitoring of patients when off the ward
clerical duties such as scheduling tests and appointments

7. ACGME Resident Survey: New Resource Available
Work hours
Clinical and educational work periods must not exceed 24 hours of continuous scheduled clinical assignments, with an additional 4 hours which may be used for activities related to patient safety, such as transitions of care and/or resident education
Additional new patient care responsibilities must not occur during these 4 hours. In rare circumstances, a resident may stay to care for a severely ill patient, attend to the humanistic needs of a patient or family, or attend a unique educational event

8. ACGME Resident Survey: New Resource Available
Work hours continued
The 80 hours limit and 1 day off in 7 are averaged over 4 weeks. For example, it is allowable to work 90 hours one week, as long as you work 70 hours in another. It is allowable to have 0 days off one week, and 2 days off the next
Included in the work hours are all in-house clinical and educational activities, clinical work done from home, and all moonlighting. Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call
See specifics on the next slide
See NY State exception on slide 10

9. ACGME Resident Survey: New Resource Available
Work hours continued
Included in 80 hour
Not included
Inpatient and outpatient clinical care
Administrative activities related to patient care, such as completing medical records, ordering and reviewing lab tests, signing orders and handoffs
For call from home: time devoted to clinical work done from home and time spent in the hospital after being called in to provide patient care
Using an electronic health record and taking calls at home
Membership time on a hospital committee
Residents’/fellows’ participation in interviewing residency/fellowship candidates
Time devoted to military commitments if that time is spent providing patient care
Reading done in preparation for the following day’s cases
Studying
Research done from home

10. Work hours: NY State exception
ACGME Resident Survey: New Resource Available
Work hours: NY State exception
In NY state, the Bell Commission requires 1 day off in 7 with no averaging. On week 1 you can be off on Sunday and work Monday through Saturday and during Week 2 work Sunday through Friday and be off on Saturday

11. Data about practice habits
ACGME Resident Survey: New Resource Available
Data about practice habits
Residents receive information about their practice habits. Examples may include hospital core measures relevant to the specialty as a whole, QI projects outcomes, hand hygiene data, or any data from the hospital about your habits as a group
This can also be data from the ambulatory setting including your panel data on chronic disease and preventive measures that you receive in clinic

12. Opportunity for scholarly activity
ACGME Resident Survey: New Resource Available
Opportunity for scholarly activity
Scholarly activity opportunities include:
PMID articles (publications in Pub Med)
Conference presentations (abstracts, posters, and presentations at international, national, regional meetings)
Quality improvement projects
Case reports
Chapters or textbooks published
Participation in funded or non-funded basic science or clinical outcomes research project
Lecture or presentation (such as grand rounds, or case presentations of at least 30 minutes duration) within the sponsoring institution or program
This does not necessarily mean you had to partake of the opportunity as the question is asking if the opportunity is available to residents

13. Working in an interprofessional team
ACGME Resident Survey: New Resource Available
Working in an interprofessional team
Interprofessional teams are those that include any of the following: fellows, nurses, pharmacists, case managers, social workers, and other allied health personnel
The teams do not have to be embedded into your rounding time, and can be external to rounding time in the inpatient setting
In clinic or ambulatory settings, this includes all work with nurses, medical assistants, pharmacists, case managers, and social workers; even if this does not occur during the patient visit

14. FEEDBACK AFTER ASSIGNMENTS
ACGME Resident Survey: New Resource Available
FEEDBACK AFTER ASSIGNMENTS
ACGME defines assignments as rotations
While you may have other assignments such as scholarly work, journal clubs, and the like that are specific to your program, this is not the purpose of this question
Feedback can be written (as in a written evaluation) or verbal – the ACGME may ask you about both

15. ACGME Resident Survey: New Resource Available
Frequency norms
Very often = very frequently, extremely often
Often = frequently, not seldom
Sometimes = on some occasions, at times
Rarely = infrequently (1-2x, <1% of the time)
Never = at no time, not ever
Note that the ACGME may consider ‘sometimes’ as potentially noncompliant, thus items in red on this slide can be considered noncompliant answers depending on the question asked
Be aware that the 5-point scale may flip between positive and negative responses being at the top or the bottom during the survey

16. Transitioning care when fatigued
ACGME Resident Survey: New Resource Available
Transitioning care when fatigued
The question is asking whether there are mechanisms in place that allow residents to transition care when they are fatigued
This can include a jeopardy system to take over call, a coverage system among in-house residents to allow the fatigued resident to go off duty, a coverage system where the fellow or attending takes over call, a way to “stop” new admits or duties and transition to another care team member

17. Logistics of the survey
ACGME Resident Survey: New Resource Available
Logistics of the survey
Your program will let you know when the survey is scheduled – typically it is a 5-week window in early spring
You will receive an from the ACGME with instructions for taking the survey. This may get routed to your junk mail folder so please check you junk mail if you can’t find the
The ACGME encourages you to ask your program for clarification regarding questions or terminology used in the survey that you do not understand