ArticleBMJ (Clinical research ed.)2009
Rate of undesirable events at beginning of academic year: retrospective cohort study.
Article in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed.
- Mentoring & support practices for final year medical students during a pandemic - 'The covid doctors'.BMC medical education · 2023Article
- Danish general practitioners as gatekeepers for gynaecological patients in regions with different density of resident specialists in gynaecology: in which situations and to whom do they refer? A cross-sectional study.Scandinavian journal of primary health care · 2023Article
- July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States.Proceedings (Baylor University. Medical Center) · 2023Article
- Debunking the July Effect in Transcatheter Interventions in Structural Heart Disease: Truth or Myth?Structural heart : the journal of the Heart Team · 2022Article
- Responsibility with a Safety Net: Exploring the Medical Student to Junior Doctor Transition During COVID-19.Medical science educator · 2022Article
- Targeted Training for Subspecialist Care in Children With Medical Complexity.Frontiers in pediatrics · 2022Article
- Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect.International journal of environmental research and public health · 2021Article
- Professional experiences in the transition of Cuban-trained South African medical graduates.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2021Article
- An Interactive Mock Paging Curriculum to Prepare New Internal Medicine Interns for Inpatient Wards.MedEdPORTAL : the journal of teaching and learning resources · 2021Article
- Do new trainees pose a threat to postoperative complications after hip fracture surgeries? Retrospective cohort of 1045 patients over a decade at a university hospital.Annals of medicine and surgery (2012) · 2020Article
- Predictors of postendoscopic retrograde cholangiopancreatography pancreatitis, analysis of more than half a million procedures performed nationwide over the last 15 years.JGH open : an open access journal of gastroenterology and hepatology · 2020Article
- Surgical Residents' Proficiency and Turnover May Affect the Overall Efficiency in an Emergency Department.World journal of surgery · 2019Article
- The "July Effect" on Shoulder Arthroplasty: Are Complication Rates Higher at the Beginning of the Academic Year?The archives of bone and joint surgery · 2018Article
- Does "July effect" exist in colonoscopies performed at teaching hospitals?Translational gastroenterology and hepatology · 2018Article
- A quality improvement intervention to enhance performance and perceived confidence of new internal medicine residents.Journal of community hospital internal medicine perspectives · 2018Article
- The impact on internship of a tailored intern preparation package.Advances in medical education and practice · 2018Article
- Is there a "July effect" in pediatric neurosurgery?Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2017Article
- Assessment of the July effect in post-endoscopic retrograde cholangiopancreatography pancreatitis: Nationwide Inpatient Sample.World journal of gastrointestinal endoscopy · 2017Article
- The July Effect in Radical Cystectomy: Mortality, Morbidity, and Efficiency.Bladder cancer (Amsterdam, Netherlands) · 2016Article
- The July Spike in Operating Room Management: Reality or Perception?Journal of graduate medical education · 2016Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether an increase in the rate of undesirable events occurs after care provided by trainees at the beginning of the academic year.
designRetrospective cohort study using administrative and patient record data.
settingUniversity affiliated hospital in Melbourne, Australia.
participants19,560 patients having an anaesthetic procedure carried out by first to fifth year trainees starting work for the first time at the hospital over a period of five years (1995-2000).
main outcome measuresAbsolute event rates, absolute rate reduction, and rate ratios of undesirable events.
resultsThe rate of undesirable events was higher at the beginning of the academic year compared with the rest of the year (absolute event rate 137 v 107 per 1000 patient hours, relative rate reduction 28%, P<0.001). The overall adjusted rate ratio for undesirable events was 1.40, 95% confidence interval 1.24 to 1.58. This excess risk was seen for all residents, regardless of their level of seniority. The excess risk decreased progressively after the first month, and the trend disappeared fully after the fourth month of the year (rate ratio for fourth month 1.21, 0.93 to 1.57). The most important decreases were for central and peripheral nerve injuries (relative difference 82%), inadequate oxygenation of the patient (66%), vomiting/aspiration in theatre (53%), and technical failures of tracheal tube placement (49%).
conclusionsThe rate of undesirable events was greater among trainees at the beginning of the academic year regardless of their level of clinical experience. This suggests that several additional factors, such as knowledge of the working environment, teamwork, and communication, may contribute to the increase.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.