A mixed-method, multi-phased approach was developed for the project’s environmental scan. This approach included a number of methods to retrieve and synthesize data:

  • Interviews with National Steering Committee members;
  • A national survey of residents, postgraduate deans, program directors and hospital administrators;
  • Analysis of current and historic provincial housestaff organization (PHO) collective agreements;
  • Literature review examining resident duty hour restriction impacts by key themes and the current status of duty hour regulations in like jurisdictions; and an
  • In-depth review of literature in six key theme areas by the Expert Working Groups

Interviews with National Steering Committee members

The project secretariat conducted one-on-one, semi-structured telephone interviews with members of the National Steering Committee. The main objective was to explore the diversity of opinions of the key stakeholder groups with respect to resident duty hour issues amongst the varied membership.

National survey of residents, postgraduate deans, program directors and hospital administrators

A quantitative survey was developed with significant input from resident and education representatives to capture the opinions of these diverse populations, on the issues relevant to resident duty hours in Canada.

Analysis of current and historic collective agreements

In Canada, regulations concerning resident duty hours are governed by Collective Agreements negotiated between the hospital or Ministry of Health (employer) and the provincial housestaff organizations representing residents (employees). As part of this project, all of the collective agreements from 1980 to the present from each PHO were analyzed.

Analysis of these agreements covered different approaches to measuring or limiting resident duty hours in Canada such as call frequency, maximum shift length, maximum hours per week, hours of rest between shifts, supervision, workload and moonlighting.

Literature review

Given the volume of primary research available on the topic, the project secretariat targeted systematic reviews of the literature related to resident duty hours. In addition, a snowball technique was used to ensure additional relevant documents were captured, including included policy documents and key position papers. The literature review aimed to collect data and information on two primary areas:

  1. The current status of resident duty hour regulations in like jurisdictions; and
  2. Impacts of resident duty hours and recent regulations to adjust resident duty hours.

Expert Working Group review

Six Expert Working Groups comprised of experts from across Canada and internationally were convened to review literature in key areas related to resident duty hours. Commentary papers summarizing in-depth literature and recommendations were submitted to the National Steering Committee for their review. Click here to learn more about the Expert Working Group Papers.

Findings from the Expert Working Groups can be found in Key Research Findings.

Want to know more?

Results of this methodology are available in Key Research Findings. For specific questions about the research approach, please contact the project secretariat.