Peabody Terrance
Department of Surgery, Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, IL 60637, USA.
Clin Orthop Relat Res. 2006 Aug;449:128-33. doi: 10.1097/01.blo.0000224037.54345.77.
In 2005 the Academic Leadership Group of the American Orthopaedic Association surveyed orthopaedic program directors, chairs, and members of the Resident Leadership Forum to gather information about the effect of the Accreditation Council for Graduate Medical Education work-hour restrictions on resident education. We compared these results with a similar survey performed 2 years ago. Ninety-four program directors and chairs and 59 senior residents responded to this survey. Overall, the respondents thought the duty hour restrictions had a negative impact on orthopaedic residency education but less so than in the previous survey. This conclusion was based on perceived negative effects on professionalism, resident operative experience, continuity of care, and increased workload for the faculty. Senior residents who worked before and after the work-hour limitations were instituted were more concerned about the negative effects than junior residents. Residents did seem more rested and content but not better prepared or necessarily more attentive. Respondents were not of the opinion resident performance had improved as measured by perceptions of performance on standardized tests. Orthopaedic departments had adapted to the work-hour limitations by scheduling night float rotations, converting in-house call to home call, and by hiring additional personnel in the form of physician extenders.
2005年，美国矫形外科学会学术领导小组对矫形外科项目主任、科室主任以及住院医师领导论坛成员进行了调查，以收集有关毕业后医学教育认证委员会工作时间限制对住院医师教育影响的信息。我们将这些结果与两年前进行的类似调查结果进行了比较。94名项目主任和科室主任以及59名高级住院医师回复了此次调查。总体而言，受访者认为工作时间限制对矫形外科住院医师教育有负面影响，但程度低于前一次调查。这一结论基于对职业素养、住院医师手术经验、护理连续性以及教员工作量增加的感知负面影响。在实施工作时间限制之前和之后工作的高级住院医师比初级住院医师更担心负面影响。住院医师似乎确实休息得更好、更满意，但准备得并没有更好，也不一定更专注。根据对标准化考试成绩的看法来衡量，受访者认为住院医师的表现并没有提高。矫形外科科室通过安排夜间轮班、将院内值班改为居家值班以及以医师助理的形式雇佣额外人员来适应工作时间限制。
