tible to fatigue-related errors because they had less experience and were less used to working long hours. While residents and program direc- tors appear to generally approve of some form of duty hour limits and other re- forms such as supervision, much of the critique focuses on the 16-hour shift lim- its for interns.
In a pair of surveys published in
March in the New England Journal of Medicine (NEJM), 72 percent of residen- cy program directors disapproved of the regulation. Three out of four directors and 52 percent of residents felt interns were less prepared to take on more se- nior roles.
The studies surveyed more than 700
residency program directors in academic and community-based institutions and more than 6,000 residents, all in an ar- ray of specialties, on the perceived ef- fects of the duty hour regulations. An overwhelming 88 percent of pro-
gram directors and 72 percent of resi- dents reported increases in patient hand- offs under the new standards, although perceived patient safety, resident fatigue, and total hours worked mostly went un- changed, despite the limits on interns. Interns’ quality of life was the only
area in which residents and program di- rectors reported notable improvements. Research published in the Journal of the American Medical Association Inter- nal Medicine in March revealed similar findings.
One study conducted at The Johns Hopkins Hospital in Baltimore showed that the number of patient handoffs rose from three under the old 30-hour shift limit to nine for those working 16-hour shifts, accompanied by perceived reduc- tions in care quality and educational opportunities. In another survey, 22 percent of in- terns who trained under the 16-hour shift limits reported committing a seri- ous medical error, compared with 19 percent of residents who did their first year of training before the new rule. That study looked at the effects of the shift limits among more than 1,300 med- ical interns in 51 residency programs and 14 university and community-based GME institutions.
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Practice Vendor Guide!
Practice Vendor Guide
2013
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