Impact of Duty Hour Restrictions on Otolaryngology Training: Divergent Resident and Faculty Perspectives

Brunworth, Joseph; Sindwani, Raj

doi:10.1097/01.mlg.0000224348.44616.fb

Cited by 43 publications

(60 citation statements)

References 11 publications

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“…Following this recommendation, a study examining the impact of these restrictions on residency training programmes from the residents' perspectives showed that most residents (67%) agreed that their mental health had improved. [14] This finding corroborates the findings of our study of the association of perceived excessive work with psychological distress.…”

Section: Discussionsupporting

confidence: 83%

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

et al. 2014

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Section: Discussionsupporting

confidence: 83%

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

et al. 2014

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“…Similar sentiments have been echoed in the otolaryngology literature, in which 69% of the otolaryngology faculty reported that the implementation of resident duty-hour restrictions had a negative effect on resident education. 3 Family medicine program directors have also expressed significant concerns about the consequences of resident duty-hour reforms, for example, decreases in professionalism among residents because of a shift mentality, the loss of continuity of care, a decrease in formal education opportunities, and the creation of expectations that may be inconsistent with the realities of practice. 10 Only 4% of program directors thought the residents fared better overall under the new regulations.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity

Jagannathan¹,

Vates

Pouratian³

et al. 2009

JNS

139

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Object. Recently, the Institute of Medicine examined resident duty hours and their impact on patient safety. Experts have suggested that reducing resident work hours to 56 hours per week would further decrease medical errors. Although some reports have indicated that cutbacks in resident duty hours reduce errors and make resident life safer, few authors have specifically analyzed the effect of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour limits on neurosurgical resident education and the perceived quality of training. The authors have evaluated multiple objective surrogate markers of resident performance and quality of training to determine the impact of the 80-hour workweek.Methods. The United States Medical Licensing Examination (USMLE)Step 1 data on neurosurgical applicants entering ACGME-accredited programs between 1998 and 2007 (before and after the implementation of the work-hour rules) were obtained from the Society of Neurological Surgeons. The American Board of Neurological Surgery (ABNS) written examination scores for this group of residents were also acquired. Resident registration for and presentations at the American Association of Neurological Surgeons (AANS) annual meetings between 2002 and 2007 were examined as a measure of resident academic productivity. As a case example, the authors analyzed the distribution of resident training hours in the University of Virginia (UVA) neurosurgical training program before and after the institution of the 80-hour workweek. Finally, program directors and chief residents in ACGME-accredited programs were surveyed regarding the effects of the 80-hour workweek on patient care, resident training, surgical experience, patient safety, and patient access to quality care. Respondents were also queried about their perceptions of a 56-hour workweek.Results. Despite stable mean USMLE Step 1 scores for matched applicants to neurosurgery programs between 2000 and 2008, ABNS written examination scores for residents taking the exam for self-assessment decreased from 310 in 2002 to 259 in 2006 (16% decrease, p < 0.05). The mean scores for applicants completing the written examination for credit also did not change significantly during this period. Although there was an increase in the number of resident registrations to the AANS meetings, the number of abstracts presented by residents decreased from 345 in 2002 to 318 in 2007 (7% decrease, p < 0.05). An analysis of the UVA experience suggested that the 80-hour workweek leads to a notable increase in on-call duty hours with a profound decrease in the number of hours spent in conference and the operating room. Survey responses were obtained from 110 program directors (78% response rate) and 122 chief residents (76% response rate). Most chief residents and program directors believed the 80-hour workweek compromised resident training (96%) and decreased resident surgical experience (98%). Respondents also believed that the 80-hour workweek threatened patient safety (96% of program directors and 78% o...

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“…However, these reforms are relatively recent. 5,6,11,14 As younger physicians begin to practice, particularly in academics, it will be interesting to see if perceptions and attitudes are ultimately different between the old and new generation of trainees. Similarly, sex did not have any effect on faculty perceptions, though women residents have previously been more favorable toward the changes than men.…”

Section: Commentmentioning

confidence: 99%

Effects of Resident Duty-Hours Restrictions on Surgical and Nonsurgical Teaching Faculty

2007

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Impact of Duty Hour Restrictions on Otolaryngology Training: Divergent Resident and Faculty Perspectives

Cited by 43 publications

References 11 publications

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity

Effects of Resident Duty-Hours Restrictions on Surgical and Nonsurgical Teaching Faculty

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