Pilot trial of IOM duty hour recommendations in neurology residency programs

Abstract

The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

The Effect of Restricting Residents' Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review

“…There were 27 studies included in the final review: 13 (48%) reviewed shift length, [23][24][25][26][27][28][29][30][31][32][33][34][35] 12 (44%) examined Across all of the studies and interventions, the impact of duty hour restrictions most frequently had no impact on patient care (5 of 10, 50%), 23,24,28,41,48 no impact on resident well-being (7 of 17, 41%), 27,34,35,41,44,46,49 and an unfavorable impact on resident education (9 of 14, 64%). 29,30,[33][34][35][36]41,43,46 A minority of studies found a favorable impact on resident well-being (4 of 17, 24%; TABLE 2).…”

“…29,30,[33][34][35][36]41,43,46 A minority of studies found a favorable impact on resident well-being (4 of 17, 24%; TABLE 2). 32,33,45,48 When analyzed by intervention type, the most frequent result of shift length changes was no impact (8 of 20, 40%), 23,24,27,28,31,32,34,35 that of night float was an unfavorable impact (10 of 18, 56%), [35][36][37][38][39][41][42][43]46,47 and for protected time for sleep, 1 study reported a favorable outcome for resident wellness (1 of 2, 50%) 48 but no impact on patient care, while the other study was unfavorable for resident well-being (1 of 2, 50%). 49 …”

Residency Training: The Review Committee for Neurology

“…The study used a control month using the 2003 ACGME duty hour requirements, and an intervention month using more restrictive requirements limiting the number of continuous hours worked. 7 During the intervention month, residents reported lower scores in quality of life, patient care, and satisfaction with education, while faculty reported lower scores on resident knowledge and quality of care. There was no improvement in resident sleepiness or increase of sleep time during the intervention month, despite the shorter shift length.…”

Use of the Electronic Health Record to Track Continuity of Care in Neurological Surgery Residency

“…17 Resident and faculty satisfaction with continuity of care learning experiences has declined since initiation of duty hour limits. 18 Clinical rotations may require adjustments to enhance continuity of care…”