Study: Limiting Shifts for Medical Trainees Improves Satisfaction Without Affecting Educational Outcomes

Johns Hopkins Hub (03/20/18) Hedin, Marin

New research shows that limiting first-year medical residents to 16-hour work shifts makes residents generally more satisfied with their training and work-life balance but leaves training directors more dissatisfied with limited educational opportunities. Researchers, who published their findings in the New England Journal of Medicine, surveyed and tracked the activities of thousands of first-year residents in 63 internal medicine training programs nationwide. The Accreditation Council for Graduate Medical Education (ACGME) in 2011 established regulations limiting interns to 16-hour shifts and more senior residents to 28-hour shifts. "Many educators have worried that the shift work created by limited duty hours will undermine the training and socialization of young physicians," says the study's principal investigator, David Asch, a professor of medicine at the University of Pennsylvania. For part of the study, trained research observers followed the daily routines of 80 interns: 44 with flexible-hour programs and 36 in limited-hour programs. The data show that the percent of time spent on direct patient care, as well as the time spent on education, was statistically the same in both program types. Scores on a national in-training exam that helps gauge medical knowledge in the second year of residency also found no difference between interns in the two arms of the study. The ongoing study, funded by the National Heart, Lung and Blood Institute and the ACGME and conducted by the Johns Hopkins School of Medicine and the Perelman School of Medicine at the University of Pennsylvania, will also look at the impact of alternative duty-hour policies on patient safety and interns' sleep patterns and alertness.

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