Study: Resident education strong despite hour limits

Concerns about patient hand-off errors remain.

By Myrle Croasdale, AMNews staff. Jan. 1/8, 2007.

Fears that residents might get more rest but less education when work-hour limits took effect in July 2003 don't appear to have come true, according to a collection of new studies.

Researchers who surveyed medical residents before the average resident workweek was capped at 80 hours and a year after the limits discovered small but significant decreases in educational opportunities. But residents continued to consider themselves clinically competent, according to "The Educational Impact of ACGME Limits on Resident and Fellow Duty Hours: A Pre-Post Survey Study" in December 2006 Academic Medicine.

"We wanted to look quickly for the possibility of a decrement in education," said Debra Weinstein, MD, a co-author of the study and vice president of graduate medical education for Partners Healthcare in Boston. "Fortunately, we didn't find that."

Individual specialties have studied work-hour reform effects, but these studies are the first to look at the issue across disciplines. Researchers queried residents from 76 programs at two large Boston teaching hospitals. They found that residents:

• Expressed that they were slightly less happy with their overall educational experience. In 2003, they found that 97.1% of residents in programs that saw a sharp reduction in hours said their overall satisfaction with their education was good or excellent, compared with 95.7% in 2004.
• Reported fewer bedside learning opportunities with faculty and less time for patient care after their hours were reduced.