A recent review of more than two dozen studies examined how duty hour restrictions have impacted patient safety, resident wellness and resident education. Researchers reviewed studies across multiple interventions and looked at the outcomes. Duty hour restrictions had an especially adverse effect on one resident outcome in particular. Think you know what it is?
The researchers reviewed 27 studies on duty hour restrictions that were completed one year prior to the implementation of the Accreditation Council for Graduate Medical Education’s 2011 regulations, according to a study in the Journal of Graduate Medical Education.
The study serves as an update to a 2010 review of literature on duty hour restrictions.
Authors of the study reviewed reports with “clearly defined intervention[s]” to implement duty hours, such as shortened shifts, night floats and protected time for sleep.
Some studies measured more than one outcome and discussed how duty hours impact:
- Patient care (discussed in 10 studies, making up 37 percent of the review)
- Resident well-being (discussed in 17 studies, 63 percent of the review)
- Resident education (discussed in 14 studies, 52 percent of the review)
Most frequently, the studies concluded that duty hour restrictions:
- Had no impact on patient care
- Had no impact on resident well-being
- Had an unfavorable impact on resident education
Authors of the literature review found that “the most frequent means of implementing duty hour restrictions” were night floats, even though this means of coping with duty hours restrictions yielded the highest proportion of unfavorable findings.
What does this mean for residents?
While acknowledging some limitations of this review, authors of the study said that these findings underscore a need for programs and institutions to reevaluate the impact of duty hours on residency training and patient care.
“Focusing on interventions to limit resident duty hours alone has not had the expected, consistent improvements to patient care,” the authors wrote. “It is time to reevaluate the profession’s approach to the issue of resident hours and its impact on patient care and residency education.”
For more of these insights on duty hour restrictions, view the literature review in the Journal of Graduate Medical Education.
Also get additional resources on balancing wellness and residency
- See how physicians rank residency work-life balance based on specialties.
- Check out these tips from residents who have conquered burnout.
- Educate yourself on the signs of burnout and how to increase satisfaction in training.
- Explore this new method one residency program devised to get rid of miserable schedules.
- Learn about this residency program intervention that decreased stress by improving documentation timeliness.
- Check out Stanford University School of Medicine’s successful wellness program, and learn why taking time for fun (and the occasional sailing lesson) can improve resiliency in training.
