24-hour on-duty shifts during the training of neurology residents in Spain: changes in the last decade
*Correspondencia: Dr. Álvaro Lambea-Gil. Instituto de Investigación Sanitaria (IIS) Aragón. Avenida San Juan Bosco, 13. E-50009 Zaragoza.
E-mail: alambea@salud.aragon.es
Introduction: The neurology training program in Spain, approved in 2006, emphasizes the importance of residents' on-duty shifts supervised by a neurologist. An evaluation of the Specialty National Commission in 2008 showed an unequal fulfillment of this goal: 60.30% of the training units offered their residents 24-hour shifts with on-duty supervision, and only 43% in their own center. After more than a decade, and a new national training program on design, we would like to know the current situation and possible factors that might be involved.
Material and methods: Cross-sectional study through self-administered surveys to neurology training units that had recently graduated residents (n = 77). Responses were collected between October 2021 and February 2022.
Results: All units answered the survey. In 2021, 88.30% met the supervision objectives, and 83% offered their trainees 24-hour on-duty shifts with a neurologist in their center. Among related factors, there is a significant direct relationship between this kind of shift, the hospital's size, and the existence of a stroke unit.
Discussion: Residents' guidance during the 24-hour neurology on-duty shifts follows the path set by the training program and the national commission. However, there are still some differences that go beyond purely healthcare aspects. The future national program could establish new guidelines that help us achieve less heterogeneity, in order to offer the same training in the assessment of acute neurological patients.
Resultados Respondió el 100% de las unidades. En 2021, el 88,3% cumplía los objetivos docentes, con un 83% con guardias de 24 horas con supervisión física en su propio centro. Entre los factores relacionados, se observó una asociación directa y estadísticamente significativa con el tamaño del centro y la existencia de unidad de ictus. Discusión. La supervisión de residentes durante la guardia de neurología está siguiendo la línea marcada por el plan formativo y la comisión nacional de la especialidad, aunque siguen existiendo diferencias que van más allá de aspectos puramente asistenciales. El futuro plan estatal podría marcar nuevas pautas que nos ayuden a conseguir una menor heterogeneidad, a fin de ofrecer una misma capacitación en el abordaje urgente del paciente neurológico.