The implementation of the European Working Time Directive in Europe and its impact on training in obstetrics and gynaecology: A ten year follow-up.

Autor: Goncalves-Henriques M; Manuel Goncalves Henriques, Hospital Professor Doutor Fernando Fonseca, IC 19, 2720-276 Amadora, Portugal; The European Network of Trainees in Obstetrics and Gynaecology. Electronic address: manuelghenriques@hff.min-saude.pt., Horala A; Agnieszka Horala, Gynecologic Oncology Department, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; The European Network of Trainees in Obstetrics and Gynaecology. Electronic address: ahorala@ump.edu.pl., Topcu EG; Elif Goknur Topcu, Kackar State Hospital, 53340 Pazar, Rize, Turkey; The European Network of Trainees in Obstetrics and Gynaecology., Boekhorst F; Ferry Boekhorst, Haaglanden Medical Center, Lijnbaan 32, 2512VA, The Hague, the Netherlands; The European Network of Trainees in Obstetrics and Gynaecology., Khattak H; Hajra Khattak, Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; The European Network of Trainees in Obstetrics and Gynaecology. Electronic address: h.khattak@doctors.org.uk.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2022 Nov; Vol. 278, pp. 1-5. Date of Electronic Publication: 2022 Sep 05.
DOI: 10.1016/j.ejogrb.2022.08.022
Abstrakt: Objective: To reassess the compliance with the European Working Time Directive (EWTD) in the member countries of the European Network of Trainees in Obstetrics and Gynaecology (ENTOG) and to investigate the impact of the EWTD on training.
Study Design: In this observational, cross-sectional study, an online questionnaire, containing multiple-choice questions and open questions, was distributed among Obstetrics and Gynaecology trainees in 33 ENTOG member countries. The questionnaire was designed as a follow-up of a similar survey conducted by ENTOG in 2009 and assessed the overall compliance with the EWTD, the adaptations needed to achieve this compliance, the impact of the EWTD on the quality of training and the well-being of trainees. The answers were analysed using descriptive statistics in Microsoft Excel.
Results: 59 responses from 28/33 (84.8%) ENTOG member countries were collected. Only 5 out of 28 (17.9%) countries were found to be nationally compliant with EWTD. There were no clear differences in the compliance between different types of the hospitals (university/teaching/district), but a trend was observed towards higher rate of implementation in smaller hospitals (<1500 deliveries per year). Regarding the changes needed to become EWTD-compliant and yet maintain high-quality training, the most common suggestions were: hiring extra junior doctors, restructuring training, having less doctors on duty simultaneously, consultants performing more hands on work, dedicated training sessions, reduction of administrative tasks and simulation training for surgical skills. The majority of trainees, 7 out of 12, (58.3%) in the EWTD-compliant hospitals experienced a positive effect on their training, whereas the majority of trainees in non-compliant hospitals, 31 out of 47, (66%) were uncertain about the impact of the EWTD on the quality of training. Among the positive changes, better work-life balance and more consultants available out of the daily working hours were listed.
Conclusions: Despite the introduction and implementation of the EWTD over two decades ago, the compliance rates across Europe remain low and seem not to have altered in the last ten years. In order to ensure the quality of training and, most importantly patient safety, we suggest that European nations keep striving to implement the EWTD for doctors in training. We also suggest for nations that have yet to implement this directive to use the strategies as an exemplar in countries that follow EWTD.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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