How accurate are self-reported resident duty hours?

Purpose: The Methodist Hospital monitors resident duty hours using self-report for external rotations and an electronic time clock system for internal rotations where residents use their identification badges to "swipe in and out." This study was conducted to compare the accuracy of self-reports against the electronic system.

Methods: This was a prospective observational study. For 1 month, surgical residents in an academic training program self-reported their duty hours and used the electronic system. The primary outcome measure was the accuracy of self-reported duty hours.

Results: Twenty two surgical residents accounted for 450 individual duty-hour periods. Sixty-four percent of the residents were men, and the distribution by postgraduate year (PGY) was PGY1 27%, PGY2 27%, PGY3 14%, PGY4 14%, and PGY5 18%. The number of missing duty-hour period reports was significantly greater for self-reports (44/450) than for the electronic system (18/450), p < 0.001. There were no statistically significant differences between either reporting method in regard to total number of duty-hour violations and individual duty-hour violations.

Conclusion: Self-report was as accurate as the electronic system in determining the occurrence of duty-hour violations. Because residents may be able to manipulate reporting in both systems, the possibility of inaccuracies exists.