 |
|
The Effects of Work-Hour Limitations on Resident Well-being, Patient Care, and Education in an Internal Medicine Residency Program
Lara Goitein, MD;
Tait D. Shanafelt, MD;
Joyce E. Wipf, MD;
Christopher G. Slatore, MD;
Anthony L. Back, MD
Arch Intern Med. 2005;165:2601-2606.
Background The Accreditation Council for Graduate Medical Education work-hour limitations (WHLs) were implemented in July 2003. Effects on resident well-being, patient care, and education are not well understood. We investigated these effects of WHLs.
Methods Self-administered survey of internal medicine residents in a university-based residency program in Seattle, Wash. Part of this survey was identical to one completed at our institution in 2001, permitting comparison of burnout, career satisfaction, and depression before and after WHLs. We surveyed 161 internal medicine residents, with 118 respondents (response rate, 73%). We measured resident well-being using the Maslach Burnout Inventory, a validated screening questionnaire for depression, and a previously described questionnaire for career satisfaction. We developed questions about overall agreement with implementation of WHLs and effects on resident well-being, patient care, and education.
Results Comparison with the 2001 survey demonstrated an increase in the proportion of residents satisfied with their career (66% to 80%; P = .02) and a decrease in the proportion meeting criteria for emotional exhaustion (53% to 40%; P = .05). Slightly more residents reported a negative effect of WHLs on patient care (37%) than they did a positive (29%) or a neutral (34%) effect, and more reported a negative effect on their education (47%) than they did a positive (32%) or a neutral (21%) effect. Overall, most residents (65%) approved of WHLs.
Conclusions Internal medicine residents approve of WHLs overall and report benefits to their well-being. However, they also report negative effects on patient care and resident education.
Author Affiliations: Division of Pulmonary & Critical Care Medicine (Dr Goitein), Department of Internal Medicine (Drs Wipf, Slatore, and Back), University of Washington, Seattle Veterans Affairs Puget Sound Health Care System (Dr Wipf), and Seattle Cancer Care Alliance (Dr Back), Seattle; and Department of Medicine, Mayo Clinic, Rochester, Minn (Dr Shanafelt).
RELATED LETTER
Resident Hours in the Pursuit of Better Health Care
Robert Bloomfield, Carolyn F. Pedley, and Elizabeth Gentile
Arch Intern Med. 2006;166(13):1423.
EXTRACT
| FULL TEXT
RELATED ARTICLES
Residency Training in the Modern Era: The Pipe Dream of Less Time to Learn More, Care Better, and Be More Professional
Patrick G. O’Malley, Janardan D. Khandekar, and Robert A. Phillips
Arch Intern Med. 2005;165(22):2561-2562.
EXTRACT
| FULL TEXT
Burnout and Internal Medicine Resident Work-Hour Restrictions
Ravi Gopal, Jeffrey J. Glasheen, Tom J. Miyoshi, and Allan V. Prochazka
Arch Intern Med. 2005;165(22):2595-2600.
ABSTRACT
| FULL TEXT
Residents Report on Adverse Events and Their Causes
Reshma Jagsi, Barrett T. Kitch, Debra F. Weinstein, Eric G. Campbell, Matthew Hutter, and Joel S. Weissman
Arch Intern Med. 2005;165(22):2607-2613.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Accreditation Council for Graduate Medical Education's Limits on Residents' Work Hours and Patient Safety: A Study of Resident Experiences and Perceptions Before and After Hours Reductions
Jagsi et al.
Arch Intern Med 2008;168:493-500.
ABSTRACT
| FULL TEXT
Rates of medication errors among depressed and burnt out residents: prospective cohort study
Fahrenkopf et al.
BMJ 2008;336:488-491.
ABSTRACT
| FULL TEXT
Career Satisfaction, Practice Patterns and Burnout among Surgical Oncologists: Report on the Quality of Life of Members of the Society of Surgical Oncology
Kuerer et al.
Ann. Surg. Oncol. 2007;14:3043-3053.
ABSTRACT
| FULL TEXT
Translational Patient Care: A New Model for Inpatient Care in the 21st Century
Phillips and Andrieni
Arch Intern Med 2007;167:2025-2026.
FULL TEXT
Burnout in Intensivists and Configuration of the Working Week
Wise and Frost
Am. J. Respir. Crit. Care Med. 2007;176:724-724.
FULL TEXT
Effects of Resident Duty-Hours Restrictions on Surgical and Nonsurgical Teaching Faculty
Vanderveen et al.
Arch Surg 2007;142:759-766.
ABSTRACT
| FULL TEXT
Effect of Residency Duty-Hour Limits: Views of Key Clinical Faculty
Reed et al.
Arch Intern Med 2007;167:1487-1492.
ABSTRACT
| FULL TEXT
Hippocrates Affirmed? Limiting Residents' Work Hours Does No Harm to Patients
Goldman and Fiebach
ANN INTERN MED 2007;147:143-144.
FULL TEXT
The Downward Spiral of Physician Satisfaction: An Attempt to Avert a Crisis Within the Medical Profession
Weinstein and Wolfe
Obstet Gynecol 2007;109:1181-1183.
FULL TEXT
Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.
West et al.
JAMA 2006;296:1071-1078.
ABSTRACT
| FULL TEXT
Resident hours in the pursuit of better health care.
Bloomfield et al.
Arch Intern Med 2006;166:1423-1423.
FULL TEXT
Residency Training in the Modern Era: The Pipe Dream of Less Time to Learn More, Care Better, and Be More Professional
O'Malley et al.
Arch Intern Med 2005;165:2561-2562.
FULL TEXT
|
