A 3-Year Study of Resident Reaction to 2011 ACGME Work Hour Rules in a Family Medicine Residency.
INTRODUCTION: 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour rules prompted concerns regarding potential negative impacts on patient care and resident education. We were interested in resident reaction to call restructuring and night oat (NF) in a family medicine residency over 3 years following implementation of the 2011 rules.
METHODS: We conducted structured interviews of residents from 2011-2012 through 2013-2014. Interviews were recorded, transcribed, and analyzed for themes.
RESULTS: Fifty-eight interviews were conducted, including 18/18 residents in 2011-2012 (100%), 18/20 residents in 2012-2013 (90%), and 22/22 residents in 2013-2014 (100%). Following introduction of the 24-hour work limit, upper year residents reported significantly less fatigue and improved personal lives, patient care, and educational experience. Reactions to NF varied with length and intensity of the NF rotation; most PGY-1 residents reported increased fatigue, more burnout, and worse personal lives on NF. Most residents felt patient care quality on NF did not differ from non-NF rotations because improved inpatient nighttime continuity mitigated effects of fatigue and increased care transitions. Reactions regarding educational experience on NF were initially negative, but improved over time.
CONCLUSIONS: Residents' reactions to 2011 ACGME work hour rules suggest the rules improved resident well-being, except on NF. Negative effects of NF may be minimized by limiting NF rotations to 5 nights/week for 2 consecutive weeks, and 1 month total per academic year.
Published In/Presented At
Picciano, A., Guth, L., & Winter, R. O. (2018). A 3-Year Study of Resident Reaction to 2011 ACGME Work Hour Rules in a Family Medicine Residency. PRiMER (Leawood, Kan.), 2, 12. https://doi.org/10.22454/PRiMER.2018.915876
Medicine and Health Sciences
Department of Family Medicine