Open Access Research article

Shifting perceptions: a pre-post study to assess the impact of a senior resident rotation bundle

Gabriel Fabreau1, Meghan Elliott1, Suneil Khanna1, Evan Minty1, Jean E Wallace2, Jill de Grood3, Adriane Lewin1, Garielle Brown3, Aleem Bharwani1, Janet Gilmour1 and Jane B Lemaire13*

Author Affiliations

1 Faculty of Medicine, Health Sciences Centre, Foothills Campus, University of Calgary, 3330 Hospital Drive NW, Calgary AB T2N 4N1, Canada

2 University of Calgary, 2500 University Dr NW, Calgary AB T2N 1N4, Canada

3 W21C Research and Innovation Center, GD01 TRW Building, 3280 Hospital Drive, NW, Calgary AB T2N 4Z6, Canada

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BMC Medical Education 2013, 13:115  doi:10.1186/1472-6920-13-115

Published: 29 August 2013



Extended duty hours for residents are associated with negative consequences. Strategies to accommodate duty hour restrictions may also have unintended impacts. To eliminate extended duty hours and potentially lessen these impacts, we developed a senior resident rotation bundle that integrates a night float system, educational sessions on sleep hygiene, an electronic handover tool, and a simulation-based medical education curriculum. The aim of this study was to assess internal medicine residents’ perceptions of the impact of the bundle on three domains: the senior residents’ wellness, ability to deliver quality health care, and medical education experience.


This prospective study compared eligible residents’ experiences (N = 67) before and after a six-month trial of the bundle at a training program in western Canada. Data was collected using an on-line survey. Pre- and post-intervention scores for the final sample (N = 50) were presented as means and compared using the t-test for paired samples.


Participants felt that most aspects of the three domains were unaffected by the introduction of the bundle. Four improved and two worsened perception shifts emerged post-intervention: less exposure to personal harm, reduced potential for medical error, more successful teaching, fewer disruptions to other rotations, increased conflicting role demands and less staff physician supervision.


The rotation bundle integrates components that potentially ease some of the perceived negative consequences of night float rotations and duty hour restrictions. Future areas of study should include objective measures of the three domains to validate our study participants’ perceptions.