Background: The Accreditation Council for Graduate Medical Education 2011 duty hour standards became effective on 7 1, 2011. One of the new standards allows residents to exceed the limit on continuous duty hours in unusual circumstances relating to patient or family need or rare educational opportunities. There are no data about how often or in what circumstances residents would consider exceeding their duty hour limits using this new provision in the standards. We surveyed internal medicine residents to explore these questions.
Methods: We conducted an anonymous cross-sectional survey of internal medicine residents at a midwestern tertiary-care hospital to determine how often they had considered exceeding duty hour limits in the preceding 2 weeks. We analyzed responses using descriptive statistics and χ(2) tests for comparisons.
Results: We obtained responses from 51 of 86 residents (59%). Of those residents, 69% (35/51) indicated that they had wanted to exceed duty hour limits at least once in the prior 2 weeks. The most common reason cited was to provide continuity of care for a patient. The 24 + 6-hour rule was the standard most likely to be broken (cited by 66%; 23/35).
Conclusions: Program leadership should anticipate that residents will commonly identify situations in which they will consider exceeding duty hour limits. It will be important to provide guidance to residents early in the year about the situations that would be appropriate for the application of this new standard.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244329 | PMC |
| http://dx.doi.org/10.4300/JGME-D-11-00069.1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Consistent direction despite wavering policy: reductions in resident physician extended duration shifts over 20 years.
Am J Med
January 2025
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA; Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
We examined data from 17,498 physicians-in-training who reported on 92,662 months of work over a 20 year study interval that included three major revisions to work hour limits. Extended duration shifts (≥24 hours; EDS) are much less common than they used to be. On average, first-year resident physicians (PGY1s) currently work a total of 4 EDS per year and 3 EDS per month during months in which any EDS are worked.
View Article and Find Full Text PDFArtificial Intelligence-Driven Approaches to Managing Surgeon Fatigue and Improving Performance.
Cureus
December 2024
Surgery, Norfolk and Norwich University Hospital, Norwich, GBR.
Surgeon fatigue significantly affects cognitive and motor functions, increasing the risk of errors and adverse patient outcomes. Traditional fatigue management methods, such as structured breaks and duty-hour limits, are insufficient for real-time fatigue detection in high-stakes surgeries. With advancements in artificial intelligence (AI), there is growing potential for AI-driven technologies to address this issue through continuous monitoring and adaptive interventions.
View Article and Find Full Text PDFThe effect of temperature constraints on the treatment of tumors using focused ultrasound-induced acoustic streaming.
Sci Rep
January 2025
SINTEF, Department of Health Research and Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology NTNU, 7491, Trondheim, Norway.
The transport of drugs into tumor cells near the center of the tumor is known to be severely hindered due to the high interstitial pressure and poor vascularization. The aim of this work is to investigate the possibility to induce acoustic streaming in a tumor. Two tumor cases (breast and abdomen) are simulated to find the acoustic streaming and temperature rise, while varying the focused ultrasound transducer radius, frequency, and power for a constant duty cycle (1%).
View Article and Find Full Text PDFUrology Resident Autonomy in the Veterans Affairs Healthcare System.
J Surg Educ
February 2025
Department of Surgery, Veterans Affairs of New Jersey Healthcare System, East Orange, New Jersey. Electronic address:
Purpose: Surgical resident autonomy in procedures has been eroding over time, due to multiple factors that include duty hour restrictions, focus on operating time, complication rate, and trust among supervising physicians. This study examines whether urology residents at the Veterans Affairs hospitals (VA) have experienced decreased surgical autonomy and contributing factors.
Methods: The national VA Surgical Quality Improvement Program (VASQIP) was queried for the most common urologic procedures between 2004 to 2019 with resident involvement.
Leveraging Lean Methodology to Improve Compliance With Work-Hour Restrictions.
JAMA Surg
December 2024
Department of Surgery, University of California, San Diego Health, La Jolla.
Importance: Since work-hour restrictions were instituted in 2003, sustainably complying with duty-hour regulations remains a challenge for general surgery residency programs across the nation.
Objective: To determine whether industry-based process improvement techniques could be leveraged to increase compliance with work-hour restrictions within a general surgery residency.
Design, Setting, And Participants: This quality improvement project using Lean methodology was conducted from October to November of the 2021 to 2022 academic year.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!