Evidence map›Paper›PMID 24503304›Full record

ArticleBMJ open2014

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

Rachel T Clarke, Alex Pitcher, Trevor W Lambert, Michael J Goldacre

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
10.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 34 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Rachel T ClarkeDepartment of Paediatric Haematology/Oncology, John Radcliffe Hospital, Oxford, UK.
Alex Pitcher
Trevor W Lambert
Michael J Goldacre
John Radcliffe Hospital · GBUniversity of Oxford · GB

Funding

British Heart Foundation FS/08/077/26366
6 · The paper itself

Abstract

objectivesTo report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS).

designAll medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010.

settingThe UK.

methodsUsing qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors.

resultsOf 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance.

conclusionsFurther work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

Indexed as

Attitude of Health PersonnelQuality of Health CareContinuity of Patient CareEducation, Medical, GraduateGuideline AdherenceGuidelines as TopicHospital AdministrationHumansInternship and ResidencyInterprofessional RelationsJob SatisfactionMoralePatient SafetyPersonnel Staffing and SchedulingPhysiciansQualitative Research

Identifiers

PMID24503304
PMCPMC3918988
OpenAlexW4318598744

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.