Effects of Limited Work Hours on Surgical Training
| Autor: | Michelle C. Specht, Catherine B. Barden, John M. Daly, Martin D. McCarter, Thomas J. Fahey |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Higher education Attitude of Health Personnel New York Personnel Staffing and Scheduling Workload Patient care Likert scale Work hours Quality of life (healthcare) Percentile rank Nursing Work Schedule Tolerance medicine Humans Pre-tertiary education Quality of Health Care business.industry Obstetrics and Gynecology Internship and Residency Resident education General Medicine Continuity of Patient Care Night float Surgical training General Surgery Family medicine Quality of Life Continuity of care Surgery sense organs business |
| Zdroj: | Journal of the American College of Surgeons. 195:531-538 |
| ISSN: | 1072-7515 |
| Popis: | BACKGROUND: Legal mandates to reduce resident work hours have prompted changes in the structure of surgical training programs. Such changes have included modification of on-call schedules and the adoption of "night float" resident coverage. Little is known about the effects of these changes on surgical resident education and perceptions of quality of patient care. STUDY DESIGN: The surgical housestaff and faculty at a single institution completed a 21-point Likert survey. Subjects were asked to compare parameters of resident education, patient care, and resident quality of life before and after institution of a strict 80-hour work week resident training schedule. The number of hours worked per week before and after these changes were reported. American Board of Surgery In-Training Examination (ABSITE) scores were compared for the 2 years before and after implementation of this schedule. Total number of surgical cases performed by graduating chief residents were recorded and compared for the 3 years before and after the schedule changes. RESULTS: Resident work hours reduced significantly after schedule changes were implemented. A majority of surgical residents reported an improvement in quality of life, but residents and faculty perceived changes to have a negative impact on continuity of patient care. Mean ABSITE composite percentile scores significantly improved after the reduction of working hours. ABSITE scores for junior residents improved significantly; no significant differences were noted in scores for senior residents. CONCLUSIONS: Reduction in resident work hours has salutary effects on perception of quality of life and basic education for surgical residents. These benefits may come at the expense of patient care, particularly continuity of care. This study did not directly assess patient outcomes but the perceptions of caregivers suggest that patient care may be compromised. Further research is needed to assess the longterm effects of changes on both residents and patients. |
| Databáze: | OpenAIRE |
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