Monday, October 17, 2011

Duty Hour Restrictions and Resident Education

A few weeks ago, I posted about the financial implications of limiting the number of hours that resident physicians can work. Dr. Schuh and others have done a study on how limiting residents' work hours impact their education.

In this study, they surveyed resident sleepiness, personal study hours, quality of life, and resident satisfaction and faculty satisfaction during two separate months - one where the residents worked the usual hours and the other where the residents worked the new hours reduction as proposed by the Institute of Medicine.

The results showed that end-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life declined in the intervention month. Resident education satisfaction declined as well, for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month too. One issue brought up by an editorial on the study was that briefer shifts mean more patient hand-offs, and this could increase physician-to-physician miscommunication and medical errors.

The study authors concluded that limiting resident work hours negatively impacts their education and that further studies are needed prior to implementing widespread duty hour changes.

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