Table 2 Changes in perceptions regarding the impact of the 24-h on-call system on three dimensions (N = 42)

  Adversely affects health

4.48 (0.92)

2.45 (1.27)

8.53

< 0.001

  Restricts participation in physical activities

4.67 (0.69)

2.38 (1.23)

11.45

< 0.001

  Impairs the ability to adapt to changes in the circadian rhythm

4.33 (0.95)

2.55 (1.33)

7.85

0.003

  Contributes to overall sleep debt

4.57 (0.70)

2.71 (1.42)

7.74

< 0.001

  Contributes to overall fatigue levels

4.74 (0.59)

2.33 (1.26)

11.92

< 0.001

  Contributes to frequent episodes of physical illness (e.g., colds)

3.90 (1.08)

2.14 (1.22)

7.9

< 0.001

  Enhances overall energy levels

2.86 (1.52)

3.60 (1.23)

2.11

0.041

  Contributes to the need to use stimulants, such as caffeine

4.40 (0.89)

2.86 (1.24)

7.5

< 0.001

  Impairs safety while driving home after an on-call

4.45 (0.86)

2.57 (1.19)

8.211

< 0.001

  Increases potential for workplace harm, such as needle-stick injuries

4.10 (1.10)

2.21 (1.22)

9.3

< 0.001

  It is easy for me to trade on-call shifts with others.

3.07 (0.89)

3.02 (1.20)

0.22

0.83

  Allows free time to accomplish non-work-related errands.

2.57 (1.33)

4.07 (1.20)

5.1

< 0.001

  Provides opportunities for spending time with family

2.0 (1.15)

4.26 (1.08)

8.5

< 0.001

  Restricts the time available for research

4.10 (0.98)

2.52 (1.27)

6.1

< 0.001

  Allows healthy interpersonal relationships

2.55 (1.06)

4.17 (0.88)

6.86

< 0.001

  Causes feelings of isolation

Causes feelings of isolation at times

4.17 (0.85)

2.60 (1.33)

6.57

< 0.001

  In general, do you feel alert during procedures while on call?

2.90 (1.1)

4.14 (0.72)

5.83

< 0.001

  Do you commit preventable medical errors?

3.64 (0.91)

2.55 (1.13)

5.23

< 0.001

  Do you experience “near misses” related to poor patient care?

3.86 (0.75)

2.52 (1.02)

6.95

< 0.001

  I am often extremely tired to provide safe patient care.

3.83 (1.06)

2.14 (1)

7.8

< 0.001

  I miss important diagnoses.

3.83 (0.88)

2.17 (0.88)

9.62

< 0.001

  I manage complex medical patients appropriately.

3.0 (1.08)

3.98 (0.87)

4.34

< 0.001

  The content of my patient care handover is accurate.

3.19 (1.06)

4.11 (0.74)

4.79

< 0.001

  I perform a thorough work-up of new admissions.

2.10 (0.96)

3.79 (1.18)

6.38

< 0.001

  Promotes continuity of patient care

I highlight important follow-up items during handover of patient care issues.

2.93 (1.24)

4.19 (0.77)

5.4

< 0.001

  I maintain continuity of patient care.

2.71 (1.42)

4.57 (0.70)

7.74

< 0.001

  I assume accountability for patients I admit.

3.57 (0.89)

4.12 (0.83)

3.41

< 0.001

  My interactions with other MTU team members are positive.

3.43 (0.99)

4.33 (0.57)

4.86

< 0.001

  I communicate well with patients and their families.

3.55 (1.04)

4.21 (0.81)

3.42

< 0.001

  I am sensitive to social issues pertaining to patient care (e.g., gender and culture)

3.19 (0.86)

3.29 (0.99)

0.703

0.486

 I can effectively multitask during busy work times.

2.67 (1.18)

4.0 (0.99)

5.99

< 0.001

 I handover patient care issues in a time-efficient manner.

2.93 (1.24)

4.19 (0.77)

5.4

< 0.001

 I respond to pagers in a timely fashion.

3.19 (1.21)

4.12 (0.86)

4.6

< 0.001

 Promotes successful teaching

  I have enough time to teach junior residents and clerks.

2.19 (0.92)

3.83 (0.93)

7.84

< 0.001

  I have enough energy to teach junior residents and clerks.

2.12 (0.92)

3.83 (1.06)

7.4

< 0.001

  I am confident in my ability to teach procedural skills.

3.10 (1.14)

3.90 (0.93)

3.14

0.003

  I am confident in my ability to teach regarding the management of unstable critically ill patients.

3.12 (1.10)

3.93 (0.95)

3.57

< 0.001

  I am confident in my ability to teach the skills required for running a code.

2.93 (1.11)

3.60 (0.96)

2.9

0.006

  I am confident in my ability to perform procedures.

3.48 (0.92)

4.14 (0.65)

3.72

< 0.001

  I am confident in my ability to manage unstable critically ill patients.

3.45 (0.80)

3.90 (0.88)

2.3

0.026

  I am confident in my ability to run a code.

3.19 (1.02)

3.71 (0.97)

2.67

0.011

  I can acquire new knowledge on call.

3.33 (1.07)

4.12 (0.80)

3.76

0.001

  I can retain new knowledge on call and apply it to patient care.

3.38 (1.08)

4.12 (0.86)

3.26

0.002

  My overall education experience on call is satisfying.

2.83 (0.99)

3.95 (0.91)

5.46

< 0.001

  I gain opportunities to learn procedures through simulation training.

3.36 (1.06)

3.86 (0.93)

2.51

0.016

  I have the opportunity to review cases with attending physicians.

2.95 (0.99)

3.79 (0.92)

4.14

< 0.001

  My clinical skills (history and physical) are observed by an attending physician.

2.33 (1.0)

3.10 (1.16)

4.1

< 0.001

  I receive feedback from attending physicians.

2.74 (1.06)

3.24 (1.19)

2.86

0.007

  My ambulatory care rotations are frequently interrupted due to MTU on-call duties.

3.95 (1.06)

2.38 (1.08)

5.55

< 0.001