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

Abstract:

OBJECTIVE:To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. METHODS:This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. RESULTS:Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. CONCLUSIONS:The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

journal_name

Neurology

journal_title

Neurology

authors

Schuh LA,Khan MA,Harle H,Southerland AM,Hicks WJ,Falchook A,Schultz L,Finney GR

doi

10.1212/WNL.0b013e31822c61c3

subject

Has Abstract

pub_date

2011-08-30 00:00:00

pages

883-7

issue

9

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e31822c61c3

journal_volume

77

pub_type

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