Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, North Carolina 28401, USA.
J Surg Educ. 2011 May-Jun;68(3):209-12. doi: 10.1016/j.jsurg.2011.01.005. Epub 2011 Mar 11.
The purpose of our study was to evaluate resident case coverage before and after the implementation of duty-hour restrictions and discuss its potential impact on surgical attendings.
We reviewed cases before (6/2002 to 6/2003) and after (6/2008 to 6/2009) the implementation of duty-hour restrictions, retrospectively.
Academic-affiliated community surgical residency program.
Full-time academic faculty and surgical residents.
Of 5253 cases performed in the year before the 80-hour workweek, 4466 (85%) were covered by residents and 787 (15%) were uncovered. Of the 6123 cases performed after the 80-hour workweek restrictions, 3694 (60%) were covered by residents and 2429 (40%) were uncovered. Despite an increase in operations and faculty, significantly fewer cases were covered by residents when comparing the time-restricted and non-time-restricted periods (85% vs 60%, p < 0.005).
The number of surgical cases without resident participation has increased significantly in the 80-hour workweek. Departments should reevaluate faculty expectations relative to time management, compensation, and nonclinical responsibilities.
我们研究的目的是评估实施工时限制前后住院医师的病例覆盖情况，并讨论其对外科主治医生的潜在影响。
我们回顾性地审查了实施工时限制前后（2002 年 6 月至 2003 年 6 月和 2008 年 6 月至 2009 年 6 月）的病例。
学术附属社区外科住院医师培训计划。
全职学术教员和外科住院医师。
在每周 80 小时工作时间之前的 5253 例手术中，有 4466 例（85%）由住院医师覆盖，787 例（15%）未覆盖。在实施每周 80 小时工作时间限制后的 6123 例手术中，有 3694 例（60%）由住院医师覆盖，2429 例（40%）未覆盖。尽管手术和教员数量有所增加，但与限制工时和非限制工时相比，由住院医师覆盖的病例数量显著减少（85%比 60%，p < 0.005）。
在每周 80 小时工作时间内，没有住院医师参与的手术数量显著增加。各部门应重新评估教员在时间管理、薪酬和非临床职责方面的期望。
