For Residents

Residents dissatisfied with new duty-hour regulations

Many residents say they are unhappy with their experiences under the Accreditation Council for Graduate Medical Education's new duty-hour regulations, with nearly half saying they disapprove of them, according to a recent survey.

The survey, published in the New England Journal of Medicine, revealed that 48.4 percent of residents disapprove of the regulations, while 51.5 percent of residents believed they are less prepared for more senior roles because of them. Meantime, 40.8 percent reported a worsened quality of education, and 43 percent claimed their work schedules were worse than before.

In addition, 73.8 percent felt that supervision levels had gone unchanged. On a positive note, 61.8 percent of respondents reported an improved quality of life for interns. The survey included responses from 6,202 residents across a broad distribution of specialties.

The survey authors suggest there may be several explanations for the negative responses. They explain that residents are working the same total number of hours, but with worsened schedules and limited increases in supervision or learning opportunities.

Additionally, the authors venture that some of the discontent comes from increased patient handoffs, which negatively affect the educational and emotional experience associated with a strong doctor-patient relationship.

The AMA works to improve the residency experience and encourages residents to view resources on improving patient handoffs.

Gaming may be helpful in learning medical skills

Could the future of resident education lie in gaming? That's a question posed by one physician in an article featured in the Journal of Graduate Medical Education.

Cor J. Kalkman, MD, writes that games, which vary in sophistication and include simulations, are increasing in popularity as they allow students to freely make errors without interrupting complex care processes or harming patients. While the idea of using simulation to educate doctors is not unique, technology is helping bring innovative new techniques to medical students and residents in training, Dr. Kalkman writes.

These games range from simulators that help fledgling surgeons develop the necessary skills and eye-hand coordination to perform laparoscopic surgery, to software programs that help residents learn to prescribe medications accurately, to full-scale simulated operating rooms, Dr. Kalkman writes.

Dr. Kalkman cautions that the usefulness of a game is dependent on its realism, and there still is a ways to go before the technology behind simulation games is perfected and ready to be widely implemented.

However, their uses already expand beyond the resident and medical student sphere. A recent New York Times article details a new interactive video game at Northwestern Memorial Hospital that helps doctors identify deceptive behavior and converse with patients suffering from pain medication dependency and abuse issues.