A. Jayaram1, C. N. Harper3, A. Chowdhury5, C. Wu4, H. Kiwanuka2, C. Huang2, T. R. Smith6,7, K. Ranganathan2 1Beth Israel Deaconess Medical Center, Surgery, Boston, MA, USA 2Brigham And Women’s Hospital, Plastic Surgery, Boston, MA, USA 3Howard University College Of Medicine, Washington, DC, USA 4University Of California – Irvine, Plastic Surgery, Orange, CA, USA 5Boston Children’s Hospital, Anesthesia, Boston, MA, USA 6Brigham And Women’s Hospital, Neurosurgery, Boston, MA, USA 7Brigham And Women’s Hospital, Computational Neuroscience Outcome Center, Boston, MA, USA
Introduction: Disruptions in the clinical and learning environment have been shown to at least double the rate of trainee reported burnout, suicidal ideation, and symptoms of depression or anxiety. Excessive paging is an example of an environmental stressor thought to increase burnout. This study aims to quantify and compare variations in paging based on demographic characteristics among surgical interns.
Methods: We conducted a retrospective review of paging data at an academic hospital for all surgical interns in General Surgery, Plastic Surgery (PRS), Urology, Neurosurgery, Orthopedic Surgery, Otolaryngology, and Obstetrics & Gynecology (OBGYN) from 2014 to 2022. Three types of pages were analyzed separately: total page number, number of pages with call back information, and number of overnight pages. We used a linear regression model to assess whether the paging behavior varied by gender and race.
Results: After excluding the automatically generated pages, 866,092 total pages, 751,711 pages with call back information, and 128,798 overnight pages from 224 surgical interns were analyzed. Among the surgical interns, 49.6% (n=111) were women, 66.1% (n=148) were White, 25.4% (n=57) were Asian, and 8.5% (n=19) were Black. Neurosurgery received the most pages on average (n=6,411) followed by Orthopedic Surgery (n=4,623), Urology (n=4,097) and General Surgery (n=4,041), PRS (n=3,720), OBGYN (n=3,230), and Otolaryngology (n=1,750). After adjusting for surgical specialties, we found that all three types of pages did not vary by gender and race. However, when looking at individual surgical specialties, we found that paging behavior varied by gender and race in PRS. On average, women received 1,696 more total pages (p=0.042), 1,518 more pages with call back information (p=0.035), and 287 more overnight-pages (p=0.014) than men in PRS; Asian surgical interns received 412 more overnight-pages than Black surgical interns in PRS.
Conclusion: Our results overall do not demonstrate gender or race-based differences in paging behaviors except in PRS. These findings highlight the importance of using mixed-methods studies with a particular focus on qualitative methodologies to further characterize the relationship between paging, interpersonal communication, and trainee well-being.
