Surgical Residents' Perception of the 16-Hour Work Day Restriction: Concern for Negative Impact on Resident Education and Patient Care

Lee, David Y.; Myers, Elizabeth A.; Rehmani, Sadiq; Wexelman, Barbara; Ross, Ruth; Belsley, Scott; McGinty, James; Bhora, Faiz Y.

doi:10.1016/j.jamcollsurg.2012.08.005

Cited by 37 publications

(25 citation statements)

References 42 publications

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“…En el caso de Perú, la jornada del interno en medicina se rige por el Decreto supremo N° 003 -2008 TR "que dicta medidas sobre jornadas máximas del […] internado en Ciencias de la Salud", el cual establece una jornada laboral máxima en establecimientos de salud del Sector Público de 6 horas diarias, 36 horas semanales o 150 horas mensuales, incluyendo las guardias nocturnas; así como un periodo de descanso no menor de cinco horas, tanto previo como posterior a las guardias nocturnas. Sin embargo, estas normas rara vez son respetadas, ya sea por imposición de los médicos que tienen a cargo a los internos, o por voluntad propia de los internos (28) , como se refleja en nuestros resultados, donde se encontró que los internos laboraron en promedio 10,0 ± 1,8 horas diarias sin contar las guardias nocturnas.…”

Section: Discussionunclassified

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

Taype-Rondán¹,

Rengifo²,

Arizabal³

et al. 2016

An Fac med

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ResumenObjetivos. Evaluar la percepción de médicos recién egresados sobre su capacitación en procedimientos médicos durante el internado, y determinar los factores asociados a recibir una adecuada capacitación en un mayor número de procedimientos, en una universidad de Lima, Perú. Diseño. Estudio observacional, transversal y analítico. Institución. Universidad de San Martín de Porres, Lima, Perú. Participantes. Médicos egresados. Métodos. Estudio tipo encuesta realizado en médicos egresados de una universidad privada de Lima, Perú, que realizaron el internado médico durante el año 2014. Se utilizó la red social Facebook para ubicar a los participantes, se obtuvo el consentimiento informado y se envió una encuesta autoaplicada con variables sociodemográficas y referentes a su internado médico. Principales medidas de resultados. Percepción sobre su capacitación en procedimientos médicos durante el internado. Resultados. Se analizaron 117 encuestas. El número de horas laboradas por día fue en promedio 10,0±1,8, la frecuencia de carga laboral excesiva y de 'papeleo excesivo' en al menos una rotación fueron 80,3% y 84,6%, respectivamente. Pocos encuestados recibieron durante su internado una adecuada capacitación en colocación de inyectables (53,9%), reducción de fracturas (28,2%) y atención de partos vaginales verticales (27,4%). Haber percibido una adecuada capacitación en más de 20 procedimientos se asoció a considerar una adecuada docencia en tres o cuatro rotaciones (RP=2,55, IC95%=1,36 a 4,76) y laborar en promedio 9 horas y 30 minutos a 10 horas y 15 minutos diarios en comparación con laborar menos horas diarias (RP=1,91, IC95%=1,01 a 3,64). Conclusiones. El exceso de carga laboral y el papeleo, así como una jornada laboral reducida, están asociados a una menor cantidad de procedimientos médicos en los que el interno se perciba adecuadamente capacitado. Es necesario implementar estrategias para mejorar la docencia en el internado. Palabras clave. Educación Médica; Formación de Recursos Humanos; Internado y Residencia. Abstract Objectives. To evaluate the perception of recently graduated physicians on their training in medical procedures during internship, and to determine factors associated to adequate training in a greater number of procedures at a university in Lima, Peru. Design. Observational, cross-sectional, analytical study. Setting. Universidad de San Martín de Porres, Lima, Peru. Participants. Recently graduated physicians. Methods. Survey study in medical graduates from a private university in Lima, Peru, who finished medical internship in 2014. Facebook social network was used to locate participants. Informed consent was obtained and a self-report survey was sent to collect sociodemographic characteristics and perceptions on their medical internship. Main outcome measures. Perception on medical procedures training during internship. Results. One hundred seventeen surveys were analyzed. The number of hours worked per day was on average 10.0 ± 1.8, the frequency of excessive workload and "excessive pa...

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Section: Discussionunclassified

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

Taype-Rondán¹,

Rengifo²,

Arizabal³

et al. 2016

An Fac med

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“…More recently, a study assessing perceptions and attitudes of surgical residents via electronic survey found that 75% of responding residents expressed dissatisfaction with the 2011 duty hour standards and a large majority (75% of PGY-1 and 94% of PGY-2 through PGY-5) expressed concerns about the adverse impact of the work hour restrictions on the education of interns [20]. …”

Section: Discussionmentioning

confidence: 99%

A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

et al. 2014

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BackgroundIn 2011, the Accreditation Council of Graduate Medical Education implemented updated guidelines for medical resident duty hours, further limiting continuous work hours for first-year residents. We sought to investigate the impact of these restrictions on graduate medical education among internal medicine residents.MethodsWe conducted eight focus groups with internal medicine residents at the University of Alabama at Birmingham in 06/2012-07/2012. Discussion questions included, “How do you feel the 2011 ACGME work hour restrictions have impacted your graduate medical education?” Transcripts of the focus groups were reviewed and themes identified using a deductive/inductive approach. Participants completed a survey to collect demographic information and future practice plans.ResultsThirty-four residents participated in our focus groups. Five themes emerged: decreased teaching, decreased experiential learning, shift-work mentality, tension between residency classes, and benefits and opportunities. Residents reported that since implementation of the guidelines, teaching was often deferred to complete patient-care tasks. Residents voiced concern that PGY-1 s were not receiving adequate clinical experience and that procedural and clinical reasoning skills are being negatively impacted. PGY-1 s reported being well-rested and having increased time for independent study.ConclusionsResidents noted a decline in teaching and are concerned with the decrease in “hands-on” clinical education that is inevitably impacted by fewer hours in the hospital, though some benefits were also reported. Future studies are needed to further elucidate the impact of decreased resident work hours on graduate medical education.

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“…One of the unintended consequences of work-hour restrictions may be a decline in this important, traditionally held value [9]. A 2012 survey of surgery residents found that 86 percent of second-to fifth-year residents in one program believed that there was a decreased level of patient ownership after the institution of the 2011 duty-hour restrictions [14].…”

Section: Patient Ownershipmentioning

confidence: 99%

2014 Winning Essay: Redefining Professionalism in an Era of Residency Work-Hour Limitations

Malouf

2015

Virtual Mentor

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Surgical Residents' Perception of the 16-Hour Work Day Restriction: Concern for Negative Impact on Resident Education and Patient Care

Cited by 37 publications

References 42 publications

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

2014 Winning Essay: Redefining Professionalism in an Era of Residency Work-Hour Limitations

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