Winslow Emily R, Berger Lisa, Klingensmith Mary E
Department of Surgery, Washington University School of Medicine, 660 South Euclid, Box 8109, St. Louis, MO 63110, USA.
Curr Surg. 2004 Nov-Dec;61(6):602-8. doi: 10.1016/j.cursur.2004.06.013.
The 80-hour work week has affected not only surgical residents but also faculty. The aim of this study was to determine the effect of resident hour restrictions on faculty hours and attitudes.
Anonymous survey.
A single, large academic medical center.
All faculty in the Departments of Surgery, Neurosurgery, Orthopedics, and Otolaryngology.
Faculty were surveyed 6 months before and 6 months after the institution of the resident 80-hour work week. Surgeons detailed hours worked over 1 week and answered yes/no questions about changes in patient care and resident education. P values were determined by Chi-square tests or Student t-tests as appropriate.
Of the 118 surveys distributed, 88 were returned (75%). Respondents were evenly divided between general surgeons (GS) and subspecialists (SS). Initially, 70% of faculty predicted that resident work-hour restrictions would increase faculty hours; however, only 47% of faculty felt that this had occurred. When current faculty work hours were compared with previously collected data, no differences were found. Faculty reported working an average of 69.9 +/- 12.2 hours per week this year, compared with 70.4 +/- 12.5 hours last year. When asked about the global impact of the 80-hour work week on faculty, 46% viewed the changes as harmful to the faculty. More concerning, 50% of all faculty felt the care their patients received was worse than previously, with only 2% feeling patient care had improved. This perception was significantly more common among GS faculty (70% GS vs 37% SS; p < 0.01), 94% of whom felt that the current lack of continuity compromises patient care. When the data were stratified by faculty work hours, interesting differences are seen. Of those faculty with work weeks less than 60 hours, only 6% thought the changes were harmful to patients and 64% thought resident training had suffered. In contrast, of those faculty who worked greater than 80 hours per week, 56% thought patients were harmed (p = 0.03) and 100% thought training had suffered (p < 0.01).
Faculty work hours have not increased in the 6 months after the institution of the 80-hour resident work week. However, the majority of the faculty feels that both patient care and resident education have deteriorated.
每周80小时的工作制不仅影响了外科住院医师，也影响了教员。本研究的目的是确定住院医师工作时间限制对教员工作时间和态度的影响。
匿名调查。
一家大型学术医学中心。
外科、神经外科、骨科和耳鼻喉科的所有教员。
在实行住院医师每周80小时工作制前6个月和后6个月对教员进行调查。外科医生详细记录了1周内的工作时间，并回答了关于患者护理和住院医师教育变化的是/否问题。根据情况，通过卡方检验或学生t检验确定P值。
在分发的118份调查问卷中，有88份被收回（75%）。受访者在普通外科医生（GS）和专科医生（SS）之间平均分配。最初，70%的教员预测住院医师工作时间限制会增加教员的工作时间；然而，只有47%的教员认为确实如此。将当前教员的工作时间与之前收集的数据进行比较，未发现差异。教员报告称，今年平均每周工作69.9±12.2小时，去年为70.4±12.5小时。当被问及每周80小时工作制对教员的总体影响时，46%的人认为这些变化对教员有害。更令人担忧的是，50%的教员认为他们的患者得到的护理比以前更差，只有2%的人认为患者护理有所改善。这种看法在普通外科教员中更为普遍（普通外科教员占70%，专科医生占37%；p<0.01），其中94%的人认为目前缺乏连续性会影响患者护理。当按教员工作时间对数据进行分层时，可以看到有趣的差异。在工作周少于60小时的教员中，只有6%的人认为这些变化对患者有害，64%的人认为住院医师培训受到了影响。相比之下，在每周工作超过80小时的教员中，56%的人认为患者受到了伤害（p=0.03），100%的人认为培训受到了影响（p<0.01）。
在实行住院医师每周80小时工作制后的6个月里，教员的工作时间没有增加。然而，大多数教员认为患者护理和住院医师教育都有所恶化。
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