Medical residents: questionnaire data reporting overtime and perceptions of safety culture, supervisor support and medical errors, a Dutch national study

Objective: The Dutch care system relies heavily on residents. This group is thought to be an especially susceptible group due to the system of hierarchy and dependence they work in. Multiple studies have related overtime, safety climate and supervision support to medical errors. The aim of this study was to study these themes and their correlations.Design: This cross-sectional questionnaire included multiple validated scales, demographic and employment data. Correlations between themes were calculated using linear regression analyses. Between-group analyses concerning residents’ current position, department, clinical setting and experience level compare mean composite scores. Setting: The survey was distributed through Dutch physician associations and social media, between February and April 2020. Participants: 492 medical residents, including trainees and resident-researchers, were included. Results: Weekly average overtime was 7.8 hours, which is mostly uncompensated. Residents not in a training program, surgical residents and those working in hospitals reported significantly more overtime. Over 1 in 3 felt they had fallen short in the quality of care they deliver. A third of respondents did not have a designated supervisor, and supervisor support scored mediocre overall. Medical errors were associated with the respondents’ scores on poorer safety climate, but other associations were not observed. Conclusions: Overtime is abundant in residents, especially in surgical specialties. Safety is a priority, but has a tendency to crumble under pressure. Strikingly, a substantial part of residents feel they have performed medical procedures that they were not properly trained for and that they have fallen short in the quality of care they deliver. Supervisor support was mostly present on development of competencies and work-related problems, but residents report poor rewarding behaviors and a third does not have a designated mentor. Medical training programs should acknowledge the importance of these themes and make a tangible effort to monitor residents’ needs and experiences.