title: Residents' quality of life during an orthopedic trauma rotation: a multicentre prospective observational study.
abstract: OBJECTIVE
  Fewer orthopedic surgery trainees are choosing careers in trauma. The impact of stressors on health-related quality of life has not been evaluated among orthopedic surgical residents. The current study aimed to determine predictors of unsatisfactory resident quality of life during trauma rotations.
  
  
  METHODS
  This was a prospective observational study in which we chose orthopedic trauma rotations within 2 training programs at 3 level 1 trauma centres. A sample of 15 orthopedic surgery residents participated in the study. The main outcome measure was the 36-Item Short-Form Health Survey taken at baseline, 2 and 6 months into the rotation. Residents ranked level of stress for 15 work-related and 13 individual problems on 5-point Likert scales.
  
  
  RESULTS
  The residents ranged from training years 1 through 5, and their mean age was 31 (standard deviation [SD] 2.8) years. Fear of error decreased at 6 months, compared with baseline (p = 0.007). Lack of time for family decreased as a problem at 2 and 6 months, compared with baseline (p = 0.025). Baseline Physical Component Summary scores were above population norms (p = 0.007). At 2 months, scores for the concept role limitations (physical) decreased significantly (p = 0.019), compared with the baseline. Mean Physical Component Summary scores declined from 57.59 (SD 3.51) at baseline to 53.68 (SD 6.50) at 2 months (p = 0.015) and 53.94 (SD 3.52) at 6 months (p = 0.008). At 2 months, mean general health scores significantly decreased, compared with baseline (p = 0.022). Social functioning scores at 6 months were decreased from population norms (p = 0.02). More resident social time was spent with medical people exclusively at 6 months, compared with baseline (p < 0.02).
  
  
  CONCLUSIONS
  Trauma rotations affect residents' emotional well-being. Training programs should equip residents with coping strategies to improve quality of life during trauma rotations.
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. ali.zahrai@utoronto.ca
authors.forename: Ali
authors.initials: A
authors.lastname: Zahrai
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
authors.forename: Amit
authors.initials: A
authors.lastname: Varma
authors.forename: William R
authors.initials: WR
authors.lastname: Rennie
authors.forename: Hans
authors.initials: H
authors.lastname: Kreder
authors.forename: David
authors.initials: D
authors.lastname: Stephen
authors.forename: Michael D
authors.initials: MD
authors.lastname: McKee
authors.forename: James P
authors.initials: JP
authors.lastname: Waddell
authors.forename: Emil H
authors.initials: EH
authors.lastname: Schemitsch
mesh_terms: D000328:Adult; D002321:Career Choice; D006305:Health Status Indicators; D006801:Humans; D007396:Internship and Residency; D009985:Orthopedics / Q000193:education*; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological; D014194:Traumatology / Q000193:education*