title: A new professionalism? Surgical residents, duty hours restrictions, and shift transitions.
abstract: BACKGROUND
  Some anticipated that the Accreditation Council for Graduate Medical Education duty hours restrictions would foster a team-focused "new professionalism" among residents. This study explores the prevalence and challenges of a new professionalism and whether they vary by program size.
  
  
  METHODS
  Questionnaires distributed in 15 general surgery programs produced an 82% response rate (N = 306); 52 semistructured follow-up interviews were completed. Results include means, percentage who "agree or strongly agree," significance tests, and main themes from the interviews.
  
  
  RESULTS
  A new professionalism is limited by residents' reluctance to pass work from day to night teams, unclear guidance regarding stay-or-go decisions during shift transitions, little educational emphasis on sign-outs, and the practice of long hours in the name of professionalism. Program size is largely unassociated with these beliefs and behaviors.
  
  
  CONCLUSIONS
  A new professionalism represents a stalled revolution among surgical residents. The new professionalism's emphasis on teamwork requires additional attention to staffing and workload management.
authors.affiliation: Department of Sociology, University of Georgia, Athens, GA 30602, USA. jimcov@uga.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Coverdill
authors.forename: Alfredo M
authors.initials: AM
authors.lastname: Carbonell
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fryer
authors.forename: George M
authors.initials: GM
authors.lastname: Fuhrman
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Harold
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Hiatt
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Jarman
authors.forename: Richard A
authors.initials: RA
authors.lastname: Moore
authors.forename: Don K
authors.initials: DK
authors.lastname: Nakayama
authors.forename: M Timothy
authors.initials: MT
authors.lastname: Nelson
authors.forename: Marc
authors.initials: M
authors.lastname: Schlatter
authors.forename: Richard A
authors.initials: RA
authors.lastname: Sidwell
authors.forename: John L
authors.initials: JL
authors.lastname: Tarpley
authors.forename: Paula M
authors.initials: PM
authors.lastname: Termuhlen
authors.forename: Christopher
authors.initials: C
authors.lastname: Wohltmann
authors.forename: John D
authors.initials: JD
authors.lastname: Mellinger
mesh_terms: D003657:Decision Making; D004503:Education, Medical, Graduate; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D010561:Personnel Staffing and Scheduling; D011364:Professional Practice; D011795:Surveys and Questionnaires; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload