Contrary to concerns that restricting work hours for surgical residents negatively affects the quality of patient care or the residents’ education, a study in the September issue of the Journal of the American College of Surgeons found that limiting work hours does not compromise education or the quality of care. In addition, the study found that the new model improved overall teaching effectiveness and increased the amount of operating room experience that residents receive.
However, researchers concluded that duty-hour restrictions could amplify job dissatisfaction and work hours among faculty and necessitate an increase in physician assistant and nurse staffing.
Four years ago, the Accreditation Council for Graduate Medical Education (ACGME) mandated the “Common Duty Hours Standard,” which required a dramatic redesign of the country's resident training programs. Among the key requirements were to limit resident work hours to no more than 80 hours per week averaged over a four-week period, restrict shifts to 30 hours, and permit at least a 10-hour rest period in between shifts. As a result of the mandate, many surgical educators were prompted to rethink their programs' organizational structures to adhere to the new requirements.
"These findings cannot be ignored. In this environment, limits on duty hours require us to reorganize our residency programs to promote high-quality education, safe patient care, and resident well-being and to carefully monitor the results of this reorganization to be sure that all of these requirements are being satisfied," Joseph R. Schneider, MD, FACS and lead author of the study, said.
The study, “Implementation and Evaluation of a New Surgical Residency Model,” which was conducted by the department of surgery at the Northwestern University Feinberg School of Medicine, involved the four core hospitals that make up the school's McGaw Medical Center. This new model included a mixture of apprenticeship, small team, and night-float models. The study evaluated the impact of their reengineered residency program and scheduling structure.
According to rotation evaluation forms completed by residents, the new program improved resident satisfaction with the quality of the teaching they received on rounds, in conferences, in the clinic and in the operating room. In addition, residents were more satisfied that they met the objectives of their rotations. The study also addressed a widespread concern that shortened resident hours would negatively affect patient care and patient outcomes. The authors found no evidence for deterioration in any patient outcome measures. In fact, continuity of care actually improved and residents were more likely to see patients after the operation as a result of the new system.
“Although duty-hour restrictions did not cause a deterioration of surgical residents' educational experience, these restrictions have the potential to produce new challenges,” added Dr. Schneider. “Faculty surveys showed perceived increases in work hours and job dissatisfaction after implementation of the new program structure. Also, 10 new physician assistant and nurse positions were hired as a result of the duty-hour restrictions.” The department of surgery at the Northwestern University Feinberg School of Medicine implemented a new residency program structure on July 1, 2003, to include a mixture of apprenticeship, small team, and night-float models. Before this change was made, the residency program used the traditional team-based approach with call being taken every third or fourth night, depending on the rotation. This study describes the organization of the new program structure and subsequent evaluation findings from measures taken over three years, beginning one year before, and completed two years after, the program implementation.
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology