title: Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: a multi-institutional study of surgical faculty and residents.
abstract: BACKGROUND
  the aim of this study was to explore professional values, value conflicts, and assessments of the Accreditation Council for Graduate Medical Education's duty-hour restrictions.
  
  
  METHODS
  questionnaires distributed at 15 general surgery programs yielded a response rate of 82% (286 faculty members and 306 residents). Eighteen items were examined via mean differences, percentages in agreement, and significance tests. Follow-up interviews with 110 participants were explored for main themes.
  
  
  RESULTS
  residents and faculty members differed slightly with respect to core values but substantially as to whether the restrictions conflict with core values or compromise care. The average resident-faculty member gap for those 13 items was 35 percentage points. Interview evidence indicates consensus over professional values, a gulf between individualistic and team orientations, frequent moral dilemmas, and concerns about the assumption of responsibility by residents and "real-world" training.
  
  
  CONCLUSIONS
  the divide between residents and faculty members over conflicts between the restrictions, core values, and patient care poses a significant issue and represents a challenge in educating the next generation of surgeons.
authors.affiliation: Department of Sociology, University of Georgia, Athens, GA, 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: Thomas H
authors.initials: TH
authors.lastname: Cogbill
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: 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: D001291:Attitude of Health Personnel; D003220:Conflict, Psychological; D004992:Ethics, Medical; D005180:Faculty, Medical; D005260:Female; D013502:General Surgery / Q000941:ethics*; D006801:Humans; D007396:Internship and Residency / Q000941:ethics*; D008297:Male; D005791:Patient Care / Q000941:ethics*; D010561:Personnel Staffing and Scheduling / Q000941:ethics*; D011795:Surveys and Questionnaires; D013997:Time Factors