MedicalResearch.com Interview with:
Ravi Rajaram MD
Division of Research and Optimal Patient Care, American College of Surgeons Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies in the Institute for Public Health and Medicine
Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Medical Research: What is the background for this study? What are the main findings?
Dr. Rajaram: The Accreditation Council for Graduate Medication Education (ACGME) first implemented restrictions to resident duty hours in 2003. In surgical populations, these reforms have not been associated with a change in patient outcomes.
However, in 2011, the ACGME further restricted resident duty hours to include: a maximum of 16 hours of continuous duty for first-year residents (interns), direct supervision of interns at all times, a maximum of 4 hours for transitions in care activities for residents in-house for 24 hours, and that these residents be given 14 hours off prior to returning to work. The association between the 2011 ACGME resident duty hour reform with surgical patient outcomes and resident education has not previously been reported.
The 2011 resident duty hour reform was not associated with a change in death or serious morbidity in the two years after the reform was implemented. Additionally, the 2011 duty hour reform was not associated with a change in any of the secondary outcomes examined, including any morbidity, failure to rescue, surgical site infection, and sepsis.
Furthermore, common measures of surgical resident education, such as in-training examination scores and board certification pass rates, were unchanged after the implementation of the 2011 duty hour reform when compared to scores prior to the reform. (more…)
MedicalResearch.com Interview with:Catherine A. Marco, MD, FACEP Professor
Department of Emergency Medicine
Wright State University
Kettering, OH 45429
Medical Research: What is the background for this study? What are the main findings?Dr. Marco: In 2003, the Accreditation Council for Graduate Medical Education (ACGME) implemented standards on duty hours and supervision. A maximum of 80 hours of duty per week were stipulated. The aim of these standards was to promote resident learning and patient safety. However, evidence has not clearly demonstrated whether the 2003 requirements improved trainee well-being or patient safety. On July 1, 2011, the ACGME implemented additional regulations on duty hours and supervision, including a 16 hour maximum shift length for PGY1 residents. The duty hours standards were implemented to ensure patient safety and provide an excellent teaching environment. Emergency Medicine has additional duty hours requirements for emergency department rotations, including a maximum of 12 continuous scheduled hours, and a maximum 60 scheduled hours per week seeing patients in the emergency department, and no more than 72 duty hours per week.
We found that among a large cohort of 4134 Emergency Medicine residents, the majority of residents stated that they are working the appropriate number of hours to practice independently at graduation. The majority of residents believe that current duty hours regulations improve patient safety. The majority of residents agreed that duty hour regulations are currently appropriate.
(more…)
MedicalResearch.com Interview with:Lauren Block, MD
Assistant Professor, North Shore–LIJ Hofstra School of Medicine
2001 Marcus Ave., Suite S160
Lake Success, NY 11042MedicalResearch.com: What are the main findings of the study?Dr. Block: Our goal was to look at how often doctors in training were performing basic niceties with their patients, such as introducing themselves and sitting down. We found that while the doctors usually asked open-ended questions and touched patients, resident physicians were unlikely to introduce themselves, explain their role, or sit down when talking to patients.
(more…)
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