Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek

Abstract

Background In 2003, the Accreditation Council for Graduate Medical Education limited resident duty hours to 80 hours per week. More than a decade later, the effect of the limits on resident clinical competence is not fully understood.

Surgical Skills Simulation Center Implementation: Healthcare Continuous Quality Improvement Project

“…These facts are consistent with an increase in the average number of cesarean sections per ObGyn resident from 191.8 in 2002-2003 to 233.4 in 2012-2013, while volumes of vaginal, forceps, and vacuum deliveries, and amniocentesis decreased [11]. Nevertheless, operative time per CD increased by a mean of 16.3 minutes from 2003-2004 to 2010-2011, p<0.001, attributable to declining trainee skill and/or increasing surgical complexity [12]. It is known that high volume surgeons can have significantly lower complication rates than low volume surgeons, p<0.001 [13].…”

Improved laparoscopic skills in gynaecology trainees following a simulation‐training program using take‐home box trainers

“…There is a reported lack of confidence among gynaecology graduates to perform the breadth of procedures in the specialty . The reduced number of real‐procedure opportunities for teaching and practise has hampered surgical training in gynaecology . Simulation allows additional opportunities for surgical training and is being increasingly used as an adjunct to traditional methods .…”

Working hours of obstetrics and gynaecology trainees in Australia and New Zealand

“…This must be balanced with safe working hours, providing continuity of patient care, training standards, teaching opportunities, professional identity and time spent with family/pursuing interests outside of work. While the restriction of working hours internationally has not appeared to significantly impact on patient outcomes there is a concern that reduced hours may adversely affect training, particularly in skill‐based specialties such as O&G . A previous study of RANZCOG trainees reported a lack of confidence in surgical skills at the completion of training .…”