Survey Evaluating Sleep Education Catalyzed Change in Residency Training
ABSTRACT
Background: Despite the high prevalence and negative effects of sleep disorders, sleep issues often remain unexplored during medical encounters. Research has shown that primary care physicians regard their knowledge as inadequate. Objective: We investigated residents’ perceived adequacy of sleep education and level of competency in diagnosing and treating sleep disorders. Methods: A questionnaire via Survey Monkey was administered to senior residents in University of California, Davis (UCD) from family medicine, internal medicine, neurology, and psychiatry to assess perception of their knowledge and training of sleep disorders. Likert scale ratings were used, from 1 (not adequate/competent) to 5 (extremely adequate/competent). Non-parametric statistical methods were used to evaluate differences in survey responses among specialties and assess the correlation between survey responses. Results: Only 33 residents responded with a 29.5% response rate. Neurology residents routinely rotate with a sleep medicine attending and subsequently reported the highest self-competency, adequacy of training, hours of didactics received and frequency of asking patients about sleep. All other residents reported receiving insufficient sleep medicine education. The combined mean score was 1.5 across the specialties regarding adequacy of sleep education in their respective medical schools with 31.3% reporting no sleep medicine training. Conclusions: This study demonstrated that there is a perceived deficit in most residents’ training and competency regarding sleep disorders. These results prompted 2 of the 4 residency programs to change their educational structure with electives in clinical sleep medicine. We believe that this paper illuminates potential need for increasing sleep medicine education throughout various levels of training. Nationwide educational research is needed to promote ACGME to incorporate the fundamentals of sleep medicine into core curriculum. Current Knowledge/Study Rationale: There are no studies, to our knowledge, directly measuring residents’ perceived adequacy of sleep medicine education provided and their perceived level of competency in diagnosing and treating sleep disorders. The aim of this study was to evaluate both the amount of time and quality of sleep education provided to residents as insufficient knowledge in addressing sleep problems may reflect gaps in educational requirements and standards within residency training. Study Impact: This study revealed a perceived deficit in most residents’ training and competency regarding sleep disorders. This study stimulated half of the UC Davis residency programs evaluated to offer electives in clinical sleep medicine suggesting that the study highlighted need for additional educational opportunities in sleep medicine.
Cite this paper
Stamm, D. , Taylor, S. , Nguyen, U. and Hardin, K. (2015) Survey Evaluating Sleep Education Catalyzed Change in Residency Training. International Journal of Clinical Medicine, 6, 444-450. doi: 10.4236/ijcm.2015.67058.
Stamm, D. , Taylor, S. , Nguyen, U. and Hardin, K. (2015) Survey Evaluating Sleep Education Catalyzed Change in Residency Training. International Journal of Clinical Medicine, 6, 444-450. doi: 10.4236/ijcm.2015.67058.
References
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http://dx.doi.org/10.4300/JGME-D-12-00364.1 [11] Johnson, T.P. and Wislar, J.S. (2012) Response Rates and Nonresponse Errors in Surveys. JAMA, 307, 1805-1806.
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http://dx.doi.org/10.1378/chest.10-0783
[1] National Institute of Health Sleep Disorders Research Plan (2011).
http://www.nhlbi.nih.gov/files/docs/resources/sleep/
201101011NationalSleepDisordersResearchPlanDHHSPublication11-7820.pdf [2] Morgenstern, M., Wang, J., Beatty, N., Batemarco, T., Sica, A.L. and Greenberg, H. (2014) Obstructive Sleep Apnea: An Unexpected Cause of Insulin Resistance and Diabetes. Endocrinology Metabolism Clinics of North America, 43, 187-204.
http://dx.doi.org/10.1016/j.ecl.2013.09.002 [3] Gupta, M.A. and Knapp, K. (2014) Cardiovascular and Psychiatric Morbidity in Obstructive Sleep Apnea (OSA) with Insomnia (Sleep Apnea plus) versus Obstructive Sleep Apnea without Insomnia: A Case-Control Study from a Nationally Representative US Sample. PLoS One, 9, e90021.
http://dx.doi.org/10.1371/journal.pone.0090021 [4] Papp, K.K., Penrod, C.E. and Strohl, K.P. (2002) Knowledge and Attitudes of Primary Care Physicians towards Sleep and Sleep Disorders. Sleep and Breathing, 6, 103-109.
http://dx.doi.org/10.1055/s-2002-34317 [5] Rosen, R., Mahowald, M., Chesson, A., et al. (1998) The Taskforce 2000 Survey on Medical Education in Sleep and Sleep Disorders. Sleep, 21, 235-238. [6] Rosen, R.C., Rosekind, M., Rosevear, C., Cole, W.E. and Dement, W.C. (1993) Physician Education in Sleep and Sleep Disorders: A National Survey of U.S. Medical Schools. Sleep, 16, 249-254. [7] Krahn, L.E., Hansen, M.R. and Tinsley, J.A. (2002) Psychiatric Residents’ Exposure to the Field of Sleep Medicine: A Survey of Program Directors. Academic Psychiatry, 26, 253-256.
http://dx.doi.org/10.1176/appi.ap.26.4.253 [8] Shen, T., Shimahara, E., Cheng, J. and Capasso, R. (2011) Sleep Medicine Clinical and Surgical Training during Otolaryngology Residency: A National Survey of Otolaryngology Residency Programs. Otolaryngology-Head and Neck Surgery, 145, 1043-1048.
http://dx.doi.org/10.1177/0194599811416765 [9] Avidan, A.Y., Vaughn, B.V. and Silber, M.H. (2015) The Current State of Sleep Medicine Education in US Neurology Residency Training Programs: Where Do We Go From Here? Journal of Clinical Sleep Medicine, 9, 281-286.
http://dx.doi.org/10.5664/jcsm.2502 [10] Magee, C., Rickards, G., Byars, L. and Artino, A.R. (2013) Tracing the Steps of Survey Design: A Graduate Medical Education Research Example. Journal of Graduate Medical Education, 5, 1-5.
http://dx.doi.org/10.4300/JGME-D-12-00364.1 [11] Johnson, T.P. and Wislar, J.S. (2012) Response Rates and Nonresponse Errors in Surveys. JAMA, 307, 1805-1806.
http://dx.doi.org/10.1001/jama.2012.3532 [12] ACGME Program Requirements for GME in Neurology (2014).
https://www.acgme.org/acgmeweb/Portals/0/PFAssets/
ProgramRequirements/180_neurology_07012014.pdf [13] Chervin, R.D., Chesson, A.L., Benca, R.M., et al. (2013) Organization and Structure for Sleep Medicine Programs at Academic Institutions: Part 1—Current Challenges. Sleep, 36, 795-801.
http://dx.doi.org/10.5665/sleep.2690 [14] Chesson, A.L., Chervin, R.D., Benca, R.M., et al. (2013) Organization and Structure for Sleep Medicine Programs at Academic Institutions: Part 2—Goals and Strategies to Optimize Patient Care, Education, and Discovery. Sleep, 36, 803-811.
http://dx.doi.org/10.5665/sleep.2692 [15] Strohl, K.P. (2011) Sleep Medicine Training across the Spectrum. Chest, 139, 1221-1231.
http://dx.doi.org/10.1378/chest.10-0783