Surgical residents’ perception of the 16-hour work day restriction: concern for negative impact on resident education and patient care

Publié le 06 février 2013 • Catégorie(s) : Conditions de travail et santé psychologique • Mot(s) clef(s) : horaires de travail

Auteur    David Y Lee
Auteur    Elizabeth A Myers
Auteur    Sadiq S Rehmani
Auteur    Barbara A Wexelman
Auteur    Ronald E Ross
Auteur    Scott S Belsley
Auteur    James J McGinty
Auteur    Faiz Y Bhora
Résumé    BACKGROUND Effective July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) instituted a 16-hour duty period limitation for postgraduate year I (PGY I) residents. Our aim was to assess the attitudes and perception of general surgery residents regarding the new duty hour limitation as well as the transfer of care process under the new guidelines. STUDY DESIGN An anonymous, web-based survey was conducted nationally 7 months after the institution of the 16-hour duty limitation. RESULTS A total of 464 completed surveys were analyzed. Overall, 75% of residents expressed dissatisfaction with the new duty hour limitation. PGY II to V residents reported a higher level of dissatisfaction compared with PGY I residents (87% vs 54%, p < 0.01). Eighty-nine percent of PGY II to V residents responded that there has been a shift of responsibilities from the PGY I class to PGY II to V residents, with 73% reporting increased fatigue as a result. Seventy-five percent of PGY I and 94% of PGY II to V residents expressed concerns about the adverse impact of the restrictions on the education of PGY I residents (p < 0.01). Residents at all PGY training levels reported encountering problems due to inadequate sign-outs (PGY I, 59%; PGY II to V, 85%; p < 0.01). Sixty-two percent of PGY I residents and 54% of PGY II to V residents believed that the new 16-hour duty restriction contributes to inadequate sign-outs (p = NS). Most PGY II to V residents (86%) believe there is a decreased level of patient ownership due to the work hour restrictions. CONCLUSIONS The results of the survey suggest that the majority of general surgery residents are concerned over the potential negative impact of the duty limitation on resident education and patient care. Further research is needed to address these concerns.
Publication    Journal of the American College of Surgeons
Volume    215
Numéro    6
Pages    868-877
Date    Dec 2012