Literature DB >> 21307391

Duty hour recommendations and implications for meeting the ACGME core competencies: views of residency directors.

Ryan M Antiel1, Scott M Thompson, Frederic W Hafferty, Katherine M James, Jon C Tilburt, Michael P Bannon, Philip R Fischer, David R Farley, Darcy A Reed.   

Abstract

OBJECTIVE: To describe the views of residency program directors regarding the effect of the 2010 duty hour recommendations on the 6 core competencies of graduate medical education.
METHODS: US residency program directors in internal medicine, pediatrics, and general surgery were e-mailed a survey from July 8 through July 20, 2010, after the 2010 Accreditation Council for Graduate Medical Education (ACGME) duty hour recommendations were published. Directors were asked to rate the implications of the new recommendations for the 6 ACGME core competencies as well as for continuity of inpatient care and resident fatigue.
RESULTS: Of 719 eligible program directors, 464 (65%) responded. Most program directors believe that the new ACGME recommendations will decrease residents' continuity with hospitalized patients (404/464 [87%]) and will not change (303/464 [65%]) or will increase (26/464 [6%]) resident fatigue. Additionally, most program directors (249-363/464 [53%-78%]) believe that the new duty hour restrictions will decrease residents' ability to develop competency in 5 of the 6 core areas. Surgery directors were more likely than internal medicine directors to believe that the ACGME recommendations will decrease residents' competency in patient care (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.5-6.3), medical knowledge (OR, 1.9; 95% CI, 1.2-3.2), practice-based learning and improvement (OR, 2.7; 95% CI, 1.7-4.4), interpersonal and communication skills (OR, 1.9; 95% CI, 1.2-3.0), and professionalism (OR, 2.5; 95% CI, 1.5-4.0).
CONCLUSION: Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation.

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Mesh:

Year:  2011        PMID: 21307391      PMCID: PMC3046937          DOI: 10.4065/mcp.2010.0635

Source DB:  PubMed          Journal:  Mayo Clin Proc        ISSN: 0025-6196            Impact factor:   7.616


  51 in total

1.  Residency reform: anticipated effects of ACGME guidelines on general surgery and internal medicine residency programs.

Authors:  Jayme D Lieberman; Judith A Olenwine; William Finley; Gary G Nicholas
Journal:  Curr Surg       Date:  2005 Mar-Apr

2.  ACGME duty-hour restrictions decrease resident operative volume: a 5-year comparison at an ACGME-accredited university general surgery residency.

Authors:  Amir Damadi; Alan T Davis; Andrew Saxe; Keith Apelgren
Journal:  J Surg Educ       Date:  2007 Sep-Oct       Impact factor: 2.891

3.  Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

Authors:  Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde
Journal:  J Biomed Inform       Date:  2008-09-30       Impact factor: 6.317

4.  Burnout and internal medicine resident work-hour restrictions.

Authors:  Ravi Gopal; Jeffrey J Glasheen; Tom J Miyoshi; Allan V Prochazka
Journal:  Arch Intern Med       Date:  2005 Dec 12-26

5.  Transfers of patient care between house staff on internal medicine wards: a national survey.

Authors:  Leora I Horwitz; Harlan M Krumholz; Michael L Green; Stephen J Huot
Journal:  Arch Intern Med       Date:  2006-06-12

6.  Resident duty hours reform: results of a national survey of the program directors and residents in neurosurgery training programs.

Authors:  Aaron A Cohen-Gadol; David G Piepgras; Satish Krishnamurthy; Richard D Fessler
Journal:  Neurosurgery       Date:  2005-02       Impact factor: 4.654

7.  Objective assessment of sleep and alertness in medical house staff and the impact of protected time for sleep.

Authors:  G S Richardson; J K Wyatt; J P Sullivan; E J Orav; A E Ward; M A Wolf; C A Czeisler
Journal:  Sleep       Date:  1996-11       Impact factor: 5.849

8.  The effect of the Accreditation Council for Graduate Medical Education Duty Hours Policy on plastic surgery resident education and patient care: an outcomes study.

Authors:  Chandrasekhar Bob Basu; Li-Mei Chen; Larry H Hollier; Saleh M Shenaq
Journal:  Plast Reconstr Surg       Date:  2004-12       Impact factor: 4.730

9.  Cost implications of reduced work hours and workloads for resident physicians.

Authors:  Teryl K Nuckols; Jay Bhattacharya; Dianne Miller Wolman; Cheryl Ulmer; José J Escarce
Journal:  N Engl J Med       Date:  2009-05-21       Impact factor: 91.245

Review 10.  Sleep deprivation and house staff performance. Update 1984-1991.

Authors:  L Leung; C E Becker
Journal:  J Occup Med       Date:  1992-12
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  33 in total

1.  The ACGME's 2011 changes to resident duty hours: are they an unfunded mandate on teaching hospitals?

Authors:  Patrick S Romano; Kevin Volpp
Journal:  J Gen Intern Med       Date:  2012-02       Impact factor: 5.128

2.  Use of the Electronic Health Record to Track Continuity of Care in Neurological Surgery Residency.

Authors:  N Scott Litofsky; Ali Farooqui; Tomoko Tanaka; Thor Norregaard
Journal:  J Grad Med Educ       Date:  2014-09

3.  The Perceived Effect of Duty Hour Restrictions on Learning Opportunities in the Intensive Care Unit.

Authors:  Nessrine Sabri; Ning-Zi Sun; Beth-Ann Cummings; Dev Jayaraman
Journal:  J Grad Med Educ       Date:  2015-03

4.  Teaching and Assessing Colorectal Surgery Residents in the Age of ACGME Competencies: Pieces of the Whole.

Authors:  Jan Rakinic
Journal:  Clin Colon Rectal Surg       Date:  2012-09

5.  Duty hours: where do we go from here?

Authors:  Paul H Rockey
Journal:  Mayo Clin Proc       Date:  2011-03       Impact factor: 7.616

6.  The times, they are a-changing: maybe we need to change too.

Authors:  Steven C Stain
Journal:  Mayo Clin Proc       Date:  2011-03       Impact factor: 7.616

7.  Think broad, act lean: implications of residency training and duty hour changes on health care costs.

Authors:  James H Tabibian
Journal:  Mayo Clin Proc       Date:  2011-07       Impact factor: 7.616

8.  2010 duty hour standards: seeing beyond the numeric limits.

Authors:  Ingrid Philibert; Thomas Nasca
Journal:  Mayo Clin Proc       Date:  2011-07       Impact factor: 7.616

9.  Inconclusive findings on effects of duty hour reduction.

Authors:  Ramani Moonesinghe; Jonathan Beard
Journal:  Mayo Clin Proc       Date:  2011-07       Impact factor: 7.616

10.  Does Increased Schedule Flexibility Lead to Change? A National Survey of Program Directors on 2017 Work Hours Requirements.

Authors:  Kathleen M Finn; Andrew J Halvorsen; Saima Chaudhry; Sanjay Desai; Denise Dupras; Shalini Reddy; Sandhya Wahi-Gururaj; Lisa Willett; Aimee K Zaas
Journal:  J Gen Intern Med       Date:  2020-08-31       Impact factor: 5.128

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