Table 2.

Studies of resident education

Source	Study Design	Population and Setting	Intervention Type	Study Outcomes	Study Quality
Afessa30	Retrospective, “before and after” controlled trial	Internal medicine residents working in the MICU at a single hospital	Transition from a Q3 call system to a model with maximum 14-h work shifts	No change in resident performance on a standardized post rotation examination.	Level II-3
Barden32	Retrospective, “before and after” controlled trial	Surgical residents at a single hospital	Reduction in ICU call frequency from Q2 to Q3; elimination of overnight call for PGY2/3 residents on other rotations via a night float system	No change in operative case volume per graduating chief resident; increase in ABSITE scores with new system.	Level II-3
Carey29	Retrospective, “before and after” controlled trial	Ob/Gyn residents at a single hospital	Reduction in extended shifts from Q3 to at most Q7, with most shifts <13 h	Increase in CREOG in-training examination scores with the new system.	Level II-3
Cockerham38	Prospective, “before and after” controlled trial	Surgical residents at a single hospital	Elimination of call for PGY 4/5 residents via a night float system	Decrease in percent of time spent on non-patient care activities with night float system.	Level II-3
de Virgilio34	Retrospective, “before and after” controlled trial	Surgical residents at a single hospital	25% reduction in call frequency for all residents	No change in ABSITE or Qualifying Examination scores; increase in total number of graduating chief resident operative cases.	Level II-3
Ferguson33	Prospective, “before and after” controlled trial	Surgical residents at a single hospital	Reduction in call frequency from Q3 to Q4	No change in mean operative volume per resident.	Level II-3
Goldstein26	Prospective, “before and after” controlled trial	Surgical residents at a single hospital	Transition from Q4 call to a night float system with 12- to 14-h shifts	No change in total number of operative cases performed by graduating chief residents.	Level II-3
Hutter25	Prospective, “before and after” controlled trial	Surgical residents at a single hospital	Reduction in call frequency from Q3 to Q4	No change in ABSITE scores; decrease in attending physician perception of resident skills.	Level II-3
Jarman37	Prospective, “before and after” controlled trial	Surgical residents at a single hospital	Transition from traditional Q3-Q4 call to a night float system with 14-h shifts	Increase in percentage of cases performed by residents after institution of night float system.	Level II-3
Kelly31	Retrospective, “before and after” controlled trial	Ob/Gyn residents at a single hospital	Transition from traditional Q3-Q4 call to a night float system with the longest shifts averaging 15.5 h	No change in total number of surgical cases on resident service or CREOG in-training examination scores.	Level II-3
Malangoni36	Prospective, “before and after” controlled trial	PGY4/5 surgical residents at a single hospital	50% reduction in call shifts per month per resident	No change in percent of operations performed by residents.	Level II-3
McElearney35	Retrospective, “before and after” controlled trial	Surgical residents at a single hospital	Elimination of extended shifts for PGY1/3 residents via transition to a night float system with 13-h shifts	No change in mean operative volume per resident per month.	Level II-3
Sawyer24	Prospective, concurrent controlled trial	Surgical interns at a single hospital	Comparison of interns on Q2, Q3, and Q4 call schedules	More operative cases per month on the Q4 call schedule.	Level II-1
Welling39	Prospective, concurrent controlled trial	Surgical residents at 2 affiliated teaching hospitals	Comparison of Q4 call schedule to night float system with maximum 13-h shifts	No change in conference attendance by residents.	Level II-1