General Surgery Residency Program, Methodist Dallas Medical Center, Dallas, TX 75203, USA.
Am J Surg. 2011 Dec;202(6):727-31; discussion 731-2. doi: 10.1016/j.amjsurg.2011.07.004. Epub 2011 Oct 8.
The Accreditation Council for Graduate Medical Education Common Program Requirements for all residency programs (effective July 1, 2011) will limit postgraduate year-1 duty hour length to 16 hours of call. Previous studies have shown some decrement in post-call task performance. We designed a study to evaluate if these decrements still exist in 2010 and to determine specifically when they occur.
Fourteen residents were tested on 4 simulator tasks during 5 separate call periods. These tasks were completed serially at 4 different time (T) intervals (T0, T12, T18, and T24) over a 24-hour period. Task performance was measured at each of these intervals. The residents completed a post-call survey.
Over the 24-hour call there was a trend toward decreased time for the completion of tasks with preservation of accuracy and efficiency. The performance of some residents actually improved and there was minimal correlation between perceived fatigue and performance.
These data show no decrease in junior or senior resident task performance over a 24-hour call period, and do not support the 2011 Accreditation Council for Graduate Medical Education maximum duty hour length of 16 hours.
自 2011 年 7 月 1 日起，住院医师规范化培训的认证理事会对所有住院医师培训计划采用的《普通项目要求》将把住院医师第一年的值班时长限制在 16 小时内。先前的研究已经表明，在值完班后，完成任务的能力会有所下降。我们设计了一项研究，以评估这些下降在 2010 年是否仍然存在，并确定它们具体在什么时候发生。
在 5 个不同的值班周期中，14 名住院医师接受了 4 项模拟器任务的测试。这些任务在 24 小时内的 4 个不同时间间隔（T0、T12、T18 和 T24）上依次完成。在每个时间间隔都对任务完成情况进行了测量。住院医师完成了一项值班后调查。
在 24 小时的值班过程中，虽然完成任务所需的时间呈下降趋势，但准确性和效率得以保持。一些住院医师的表现实际上有所提高，而且感知到的疲劳与表现之间几乎没有相关性。
这些数据表明，在 24 小时的值班周期内，初级和高级住院医师的任务表现并没有下降，也不支持 2011 年认证理事会对住院医师培训的最长值班时长为 16 小时的规定。
