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Quantitative and qualitative perceptions of the 2011 residency duty hour restrictions: a multicenter, multispecialty cross-sectional study.

作者信息

Tierney William S, Elkin Rachel L, Nielsen Craig D

机构信息

Cleveland Clinic Education Institute, 9500 Euclid Avenue, NA2-17, Cleveland, OH, 44195, USA.

出版信息

BMC Med Educ. 2015 Mar 25;15:57. doi: 10.1186/s12909-015-0323-4.


DOI:10.1186/s12909-015-0323-4
PMID:25889722
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4403846/
Abstract

BACKGROUND: July 2011 saw the implementation of the newest duty hour restrictions, further limiting the working hours of first year residents and necessitating a variety of adaptations on the part of residency programs. The present study sought to characterize the perceived impact of these restrictions on residency program personnel using a multi-specialty and multi-site approach. METHODS: We developed and administered a survey to internal medicine and general surgery residency programs at three academic medical centers within an urban region. The survey combined quantitative and qualitative components to gain a broader understanding of the impact of the newest regulations. Quantitative responses were compared between Internal Medicine and General Surgery programs with Student t-tests. Other comparisons were performed using ANOVA or Kruskal-Wallis testing as appropriate. For all comparisons, the threshold for significance was set at 0.01. Two independent reviewers coded all qualitative data and assigned one or more themes based on content. Descriptive statistics were calculated and the diversity of themes identified. No between-group comparisons were conducted with the qualitative data. RESULTS: We found significant differences in the overall perceptions of duty hour restrictions across specialty (internal medicine more positive than general surgery) and across position (first year residents more positive than senior residents and faculty). Notably, individuals who trained at osteopathic medical schools reported significantly more negative views of the duty hour restrictions than those who had trained at allopathic or international medical schools, suggesting an influence of undergraduate medical training. The complementary qualitative data offered insights into the perceived strengths and weaknesses of the duty hour restrictions, as well as actionable suggestions that could help to improve residency program function. CONCLUSION: This study characterizes responses to the new duty hour restrictions from a variety of perspectives. Our findings show that individual (type of undergraduate medical education, role in graduate medical education) and program-wide (e.g., specialty) factors contribute to participant satisfaction with DHR. This research highlights the value of a mixed methods approach in the study of duty hour restrictions, with our qualitative arm yielding rich data that complemented and expanded upon the insights derived from the quantitative data.

摘要

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Quantitative and qualitative perceptions of the 2011 residency duty hour restrictions: a multicenter, multispecialty cross-sectional study.

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引用本文的文献

[1]
Resident Survey on Gastroenterology Training in Canada.

J Can Assoc Gastroenterol. 2019-4

[2]
Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

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[3]
A 15-year review of the Stanford Internal Medicine Residency Program: predictors of resident satisfaction and dissatisfaction.

Adv Med Educ Pract. 2017-8-2

本文引用的文献

[1]
Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

JAMA Intern Med. 2013-4-22

[2]
Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal cohort study.

JAMA Intern Med. 2013-4-22

[3]
The effect of reducing maximum shift lengths to 16 hours on internal medicine interns' educational opportunities.

Acad Med. 2013-4

[4]
The 2011 duty-hour requirements--a survey of residency program directors.

N Engl J Med. 2013-2-21

[5]
Effects of duty hour restrictions on core competencies, education, quality of life, and burnout among general surgery interns.

JAMA Surg. 2013-5

[6]
Residents' response to duty-hour regulations--a follow-up national survey.

N Engl J Med. 2012-6-14

[7]
Anticipated consequences of the 2011 duty hours standards: views of internal medicine and surgery program directors.

Acad Med. 2012-7

[8]
Internal medicine trainees' views of training adequacy and duty hours restrictions in 2009.

Acad Med. 2012-7

[9]
Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.

Neurology. 2011-7-27

[10]
Effect of 16-hour duty periods on patient care and resident education.

Mayo Clin Proc. 2011-2-9

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