Surgical Residents' Perception of the 16-Hour Work Day Restriction: Concern for Negative Impact on Resident Education and Patient Care
Journal of the American College of SurgeonsPublished 4 October 2012
David Y. Lee, Elizabeth A. Myers, Sadiq Rehmani, Barbara Wexelman, Ronald E. Ross, Scott Belsley
Citations37
SJR quartileQ1
SJR score1.23
SNIP1.35
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The results of the survey suggest that the majority of general surgery residents are concerned over the potential negative impact of the duty limitation on resident education and patient care.
Abstract
The results of the survey suggest that the majority of general surgery residents are concerned over the potential negative impact of the duty limitation on resident education and patient care. Further research is needed to address these concerns.
Keywords
PsychologyMedicine
New England Journal of MedicineEffect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
1,759 Citations2004Christopher P. Landrigan, Jeffrey M. Rothschild +9 more
New England Journal of MedicineEffect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures
920 Citations2004Steven W. Lockley, John Cronin +10 more
Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.
New England Journal of MedicineThe New Recommendations on Duty Hours from the ACGME Task Force
548 Citations2010Thomas J. Nasca, Susan Day +1 more
Proposed modifications in the current requirements for medical residency training programs, including in the limits on resident hours, are explained and input on the new requirements is invited.
PLoS MedicineImpact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures
521 Citations2006Laura K. Barger, Najib Ayas +5 more
In a Web-based survey, extended-duration work shifts were associated with an increased risk of significant medical errors, adverse events, and attentional failures in interns across the United States.
Annals of SurgeryThe Impact of the 80-Hour Resident Workweek on Surgical Residents and Attending Surgeons
397 Citations2006Matthew M. Hutter, Katherine C. Kellogg +3 more
Although the mandated restriction of resident duty hours has had no measurable impact on the quality of patient care and has led to improvements for the current quality of life of residents, there are many concerns with regards to the training of professional, responsible surgeons for the future.
Annals of SurgeryWilliam Stewart Halsted
344 Citations1997John L. Cameron
There is perhaps no story in medical science over the past 100 years more fascinating than the life of Dr. William Stewart Halsted, generally regarded as the most innovative and influential surgeon the United States has produced.
JAMAEffects of Work Hour Reduction on Residents’ Lives
328 Citations2005Kathlyn E. Fletcher, Willie Underwood +4 more
Past interventions suggest that residents' quality of life may improve with work hour limitations, but interpretation of the outcomes of these studies is hampered by suboptimal study design and the use of nonvalidated instruments.
JAMAMortality Among Hospitalized Medicare Beneficiaries in the First 2 Years Following ACGME Resident Duty Hour Reform
323 Citations2007Kevin G. Volpp, Amy K. Rosen +7 more
The ACGME duty hour reform was not associated with either significant worsening or improvement in mortality for Medicare patients in the first 2 years after implementation.
The American Journal of SurgeryEffect of sleep deprivation on the performance of simulated laparoscopic surgical skill
304 Citations2003Brian J. Eastridge, Elizabeth C. Hamilton +6 more
Call-associated sleep deprivation and fatigue are associated with increased technical errors in the performance of simulated laparoscopic surgical skills in the MIST VR surgical simulator.
Academic MedicineThe Effects of Sleep Loss and Fatigue on Resident–Physicians: A Multi-Institutional, Mixed-Method Study
303 Citations2004Klara K. Papp, Eleanor Palo Stoller +7 more
More residents perceived that sleep loss and fatigue had major impact on their personal lives during residency, leaving many personal and social activities and meaningful personal pleasures deferred or postponed, and further substantiates the growing concern about the potential impact on professional development.
Journal of the American College of SurgeonsA randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours
266 Citations2005Erik G. Van Eaton, Karen D. Horvath +3 more
Journal of the American College of SurgeonsCumulative Operative Experience Is Decreasing During General Surgery Residency: A Worrisome Trend for Surgical Trainees?
244 Citations2008John C. Kairys, Kandace P. McGuire +2 more
Archives of SurgeryEffect of the 80-Hour Workweek on Resident Burnout
210 Citations2004Dmitri V. Gelfand
Despite successful reductions in resident work hours, measures of burnout were not significantly affected and important clinical activities such as time spent in the operating room, clinic, and making rounds were maintained.
The American Journal of SurgeryEffect of the 80-hour work week on resident operative experience in general surgery
162 Citations2007Arthur M. Carlin, Enej Gasevic +1 more
The mandated work-hour guidelines have negatively impacted the operative experience of general surgery residents, especially at the junior level, and despite implementing modifications designed to optimize resident operative experience, surgical training programs may require further adaptations.
Journal of surgical educationSimple Standardized Patient Handoff System that Increases Accuracy and Completeness
140 Citations2008Jeffrey D. Wayne, Rajesh Kumar Tyagi +5 more
By simplifying and standardizing the handoff instrument, this study demonstrated improvements in resident perceptions of accuracy, completeness, and number of tasks transferred.
Annals of SurgeryResident Work Hour Limits and Patient Safety
131 Citations2005Benjamin K. Poulose, Wayne A. Ray +7 more
Resident work hour limits in New York teaching hospitals were not associated with improvements in surgical patient safety measures, with worsening trends observed in APL and PEDVT corresponding with enforcement.
Current SurgeryEffect of Work-hour Reforms on Operative Case Volume of Surgical Residents
116 Citations2005Charles M. Ferguson, Katherine C. Kellogg +2 more
A careful but aggressive plan of work-hour reduction was devised for the residency of the authors' institution with the goal to decrease work hours while maintaining optimal patient care and resident education, including operative case volume.
Academic MedicineEffect of the ACGME Duty Hours Restrictions on Surgical Residents and Faculty: A Systematic Review
111 Citations2010Mohammad H. Jamal, Mathieu Rousseau +4 more
The largest and most current review of the literature addressing the effect of the ACGME duty hours limitations on surgical training, finding that limitations had a positive effect on residents but a negative effect on surgical faculty.
Current SurgeryThe 80-Hour Resident Workweek Does Not Adversely Affect Patient Outcomes or Resident Education
100 Citations2006Christian de Virgilio, Arezou Yaghoubian +3 more
The reorganization of the authors' general surgery residency program to comply with the duty hour restrictions was achieved within reasonable cost and the quality of surgical resident education, as measured by operative volumes, ABSITE scores, and written and oral board examination pass rates were likewise unchanged.
Journal of surgical educationThe Impact of Work Hour Restrictions on Surgical Resident Education
95 Citations2008Emily T. Durkin, R.J. McDonald +2 more
The effect of reduced work hours on resident standardized test scores and operative volume at an institution was determined and an unexpected consequence of work-hour restrictions may be an improvement in surgical resident education.
Journal of the American College of SurgeonsMotivation to Pursue Surgical Subspecialty Training: Is There a Gender Difference?
89 Citations2007Jaime H. McCord, R.J. McDonald +5 more
Findings suggest that general surgical residency programs might improve efforts to recruit women by addressing the perception of the lifestyle associated with choosing a surgical career.
Journal of the American College of SurgeonsResident Work Hour Restrictions: Where Are We Now?
85 Citations2008Myriam J. Curet
New England Journal of MedicineAn Elusive Balance — Residents' Work Hours and the Continuity of Care
84 Citations2007Susan Okie
New England Journal of MedicineACGME Duty-Hour Recommendations — A National Survey of Residency Program Directors
80 Citations2010Ryan M. Antiel, Scott M. Thompson +6 more
Proposed new recommendations represent an attempt to address elements of the 2003 ACGME standards that generated "excellent and safe patient care" standards.
Archives of SurgeryResident Operative Experience During the Transition to Work-Hour Reform
75 Citations2005Kathryn A. Mendoza
There were no significant differences in the operative volume of chief residents based on work-hour model, program setting, or graduating class, and there was an inverse relationship found between work hours and operative volume for residents in New York programs.
Academic MedicineUsing Direct Observation, Formal Evaluation, and an Interactive Curriculum to Improve the Sign-Out Practices of Internal Medicine Interns
70 Citations2010Bhavna Gakhar, Abby L. Spencer
A new curriculum with didactic and interactive components to target intern-level and system-level problems was developed and helped interns develop skills required by the Accreditation Council for Graduate Medical Education, including competencies in communication, practice-based learning, and systems-based practice.
Journal of surgical educationImpact of the 80-Hour Workweek on Surgical Case Exposure Within a General Surgery Residency Program
68 Citations2010Daniel Watson, Timothy D. Flesher +2 more
The data suggest that the impact of the 80-hour workweek has had a detrimental effect on the conventional resident training experience as seen in the increase in the total number of major operative cases available and the volume of cases performed by residents.
Archives of SurgeryImpact of the 80-Hour Workweek on Patient Care at a Level I Trauma Center
60 Citations2007Alí Salim
There was a significant increase in total, preventable, and nonpreventable complications among adult trauma surgical patients admitted before and after the 80-hour workweek limitation.
SurgeryMaintaining outcomes in a surgical residency while complying with resident working hour regulations
51 Citations2002James M. Hassett, Ruth H. Nawotniak +5 more
Complying with working hour regulations improves the quality of a resident's life and can be achieved while maintaining procedural experience and guaranteeing academic development.
Archives of SurgerySurgical Training, Duty-Hour Restrictions, and Implications for Meeting the Accreditation Council for Graduate Medical Education Core Competencies
48 Citations2012Ryan M. Antiel, Kyle J. Van Arendonk +10 more
Although less pessimistic than program directors, interns beginning their training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.
Mayo Clinic ProceedingsEffect of 16-Hour Duty Periods on Patient Care and Resident Education
43 Citations2011Christopher McCoy, Andrew J. Halvorsen +3 more
Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents, however, cross-cover of care, quality of education, and time off between shifts may be adversely affected.
Perspectives in biology and medicineWhere Have All the Giants Gone?: Reconciling Medical Education and the Traditions of Patient Care with Limitations on Resident Work Hours
41 Citations2003Jerome Lowenstein
The intensity of patient care in teaching hospitals today is far greater than it was in the past and changes in medical care make it critical to develop new programs that will reconcile rigorous, scientifically based humanistic medicine with the needs of patients and physicians.
SurgeryPsychologic well-being of surgery residents after inception of the 80-hour workweek: A multi-institutional study
39 Citations2005Shahram Zare, Joseph A. Galanko +7 more
Inception of the 80-hour workweek is associated with reduced psychologic distress among surgery residents and the perception of stress and academic performance remains unchanged.
Journal of Cancer EducationImpact of the Recent Reduction in Working Hours (The 80 Hour Work Week) on Surgical Resident Cancer Education
32 Citations2005John T. Vetto, Debra Robbins
Overall, the recent reduction in work hours does not appear to have changed residents' experience with cancer patient care, although possible early reductions in attendance at cancer operations and tumor boards merits further study and possibly future schedule changes.
The American Journal of SurgeryLimiting resident duty hours
28 Citations2003Lazar J. Greenfield
The Residency Review Committee for Surgery monitors programs for working conditions and will be enforcing new regulations from the Accreditation Council for Graduate Medical Education.
Current SurgeryReducing the noneducational and nonclinical workload of the surgical resident
23 Citations2003Yale D. Podnos, Russell A. Williams +4 more
This study shows that health technicians can be effective in reducing the overall hours and workload of surgical residents and increasing time spent in the operating room.
The American SurgeonAfter-Hours Complications: Evaluation of the Predictive Accuracy of Resident Sign-Out
18 Citations2010Vincent C. Scoglietti, Kristin T. Collier +4 more
Residents signing out to the night coverage team were asked to identify two patient groups: problem patients who were especially ill and likely to present specific clinical problems; and nonproblem patients who are likely not to be at risk for a problem requiring attention.
Journal of surgical educationComputerized Rounding in a Community Hospital Surgery Residency Program
4 Citations2007John Park, Kevin Tymitz +2 more
The hypothesis that the prerounding time dramatically decreases with the PDA compared to without not only helps to keep residents under the 80-hour work week rule, but also it helps to eliminate much of the confusion that can cause patient safety issues.
Journal of Graduate Medical EducationAn Assessment Tool for Aseptic Technique in Resident Physicians: A Journey Towards Validation in the Real World of Limited Supervision
4 Citations2010Monica L. Lypson, Stanley J. Hamstra +3 more
The validation study showed that the instrument exhibited reliability and evidence for validity, making it useful for the assesment of aseptic technique skills in different specialties.