First-Year Ophthalmology Residency Call Structure and Its Association with Resident Anxiety and Confidence

Abstract

Purpose The main purpose of this article is to characterize methods for preparing first-year ophthalmology residents for call and to evaluate the association between call structure and anxiety levels.

Methods Data on call structure and preparatory courses were collected by a national online survey of residency program directors and first-year residents in 2016 and 2017. Anxiety was assessed using the Endler Multidimensional Anxiety Scale, and confidence in evaluating and managing critical diagnoses on call was evaluated using a modified Likert-type scale.

Results In 2016, 132 first-year ophthalmology residents (28% of 465 total) responded to the survey, and in 2017, 103 first-year residents (22% of 469 total) responded, for a total of 235 residents participating. About 97.4% of residents reported that their residency program had a buddy call system, and 73.2% reported that their residency offered a preparatory course at the beginning of residency. In the resident cohort from 2017, there was a statistically significant association between length of buddy call duration and cognitive worry anxiety level (p = 0.01) with the lowest mean anxiety scores reported among those whose buddy call system lasted between 9 and 12 weeks. Higher confidence in making critical diagnoses on call was significantly associated with lower anxiety scores (p < 0.05 for all surveyed diagnoses). In the 2016 cohort, the mean cognitive worry score was significantly lower in those who had a preparatory course than those who did not (17.6 vs 22.2, p = 0.02), as was the mean overall anxiety score (33.8 vs 40.8, p = 0.04).

Conclusion Buddy call and preparatory courses are associated with less anxiety and improved confidence among residents on call.

Keywords

residency - primary call - call structure - anxiety - confidence

Note

This study was presented at the Association of University Professors in Ophthalmology Annual Meeting in January 2017 and at the Association for Research in Vision and Ophthalmology Meeting in May 2017 by Dr. Akosua Nti as a poster presentation but has not been submitted for consideration with another journal.

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