BACKGROUND: The Accreditation Council for Graduate Medical Education duty hour standards restrict continuous duty for postgraduate year (PGY)-1 residents to 16 hours. OBJECTIVE: We aimed to assess the relationship between a duty hour-compliant schedule and resident sleep. METHODS: To comply with 2011 duty hour limits, Beth Israel Deaconess Medical Center restructured its intensive care unit call model for internal medicine PGY-1 residents from a traditional shift model to an overlapping shorter-duration shift model with preserved educational periods. Before and after schedule changes, we used daily surveys of PGY-1 residents to collect self-reported data on quantity and quality of sleep and quality of education. RESULTS: A total of 1162 surveys were sent to 43 interns before scheduling changes, and 1305 were sent to 41 interns after the changes. Response rate was 31.2% (362 of 1161) before and 22.2% (290 of 1305) after. Before changes, 57.7% (209 of 362) reported receiving 6 hours or more of sleep in a 24-hour period compared to 72.4% (210 of 290) after the changes (adjusted relative risk, 1.33; 95% CI, 1.15-1.53), with an adjusted difference of 0.83 hours of sleep per 24 hours (95% CI, 0.28-1.38). After the intervention, on a 5-point Likert scale, residents reported higher quality of sleep (odds ratio [OR], 1.62; 95% CI, 1.01-2.60) and greater satisfaction with their education (OR, 2.59; 95% CI, 1.40-4.81). CONCLUSIONS: Following conversion to a duty hour-compliant model with preserved didactic time, PGY-1 residents reported minor increases in quantity and quality of sleep per 24-hour period, and increased satisfaction with the educational experience.
BACKGROUND: The Accreditation Council for Graduate Medical Education duty hour standards restrict continuous duty for postgraduate year (PGY)-1 residents to 16 hours. OBJECTIVE: We aimed to assess the relationship between a duty hour-compliant schedule and resident sleep. METHODS: To comply with 2011 duty hour limits, Beth Israel Deaconess Medical Center restructured its intensive care unit call model for internal medicine PGY-1 residents from a traditional shift model to an overlapping shorter-duration shift model with preserved educational periods. Before and after schedule changes, we used daily surveys of PGY-1 residents to collect self-reported data on quantity and quality of sleep and quality of education. RESULTS: A total of 1162 surveys were sent to 43 interns before scheduling changes, and 1305 were sent to 41 interns after the changes. Response rate was 31.2% (362 of 1161) before and 22.2% (290 of 1305) after. Before changes, 57.7% (209 of 362) reported receiving 6 hours or more of sleep in a 24-hour period compared to 72.4% (210 of 290) after the changes (adjusted relative risk, 1.33; 95% CI, 1.15-1.53), with an adjusted difference of 0.83 hours of sleep per 24 hours (95% CI, 0.28-1.38). After the intervention, on a 5-point Likert scale, residents reported higher quality of sleep (odds ratio [OR], 1.62; 95% CI, 1.01-2.60) and greater satisfaction with their education (OR, 2.59; 95% CI, 1.40-4.81). CONCLUSIONS: Following conversion to a duty hour-compliant model with preserved didactic time, PGY-1 residents reported minor increases in quantity and quality of sleep per 24-hour period, and increased satisfaction with the educational experience.
Authors: Katherine A Auger; Christopher P Landrigan; Javier A Gonzalez del Rey; Kira R Sieplinga; Heidi J Sucharew; Jeffrey M Simmons Journal: Acad Pediatr Date: 2012-05-22 Impact factor: 3.107
Authors: Steven W Lockley; John W Cronin; Erin E Evans; Brian E Cade; Clark J Lee; Christopher P Landrigan; Jeffrey M Rothschild; Joel T Katz; Craig M Lilly; Peter H Stone; Daniel Aeschbach; Charles A Czeisler Journal: N Engl J Med Date: 2004-10-28 Impact factor: 91.245
Authors: Christopher P Landrigan; Jeffrey M Rothschild; John W Cronin; Rainu Kaushal; Elisabeth Burdick; Joel T Katz; Craig M Lilly; Peter H Stone; Steven W Lockley; David W Bates; Charles A Czeisler Journal: N Engl J Med Date: 2004-10-28 Impact factor: 91.245
Authors: Judy A Shea; Lisa L Willett; Karen R Borman; Kamal M F Itani; Furman S McDonald; Stephanie A Call; Saima Chaudhry; Michael Adams; Karen M Chacko; Kevin G Volpp; Vineet M Arora Journal: Acad Med Date: 2012-07 Impact factor: 6.893
Authors: Ryan M Antiel; Scott M Thompson; Darcy A Reed; Katherine M James; Jon C Tilburt; Michael P Bannon; Philip R Fischer; David R Farley Journal: N Engl J Med Date: 2010-08-04 Impact factor: 91.245
Authors: Sanjay V Desai; Leonard Feldman; Lorrel Brown; Rebecca Dezube; Hsin-Chieh Yeh; Naresh Punjabi; Kia Afshar; Michael R Grunwald; Colleen Harrington; Rakhi Naik; Joseph Cofrancesco Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873