Restricting residents' working hours decreases teaching time but improves well-being
Research Activities, May 2010, No. 357
Medical residents are indispensible to academic hospitals. Not only do they take care of patients, but they are also responsible for teaching medical students. Yet to improve patient safety, residents nationwide are only allowed to work up to 80 hours per week with no more than 30 consecutive hours. The amount of time residents spend teaching has declined as a result of these work hour restrictions, according to a new study. However, residents report feeling less exhausted and more satisfied with the level of care they deliver.
At a large academic medical center in California, 125 residents responded to a survey designed to measure various aspects of their working situation. These included the time spent teaching, the number of hours worked, satisfaction with patient care, and how exhausted they felt. Nearly a quarter (24 percent) of respondents reported spending less time teaching. This finding supports previous work suggesting that duty hour restrictions may have some negative effects on resident education, note the researchers. They found that spending less time teaching was associated with working less than 80 hours a week, being a second- or third-year resident, and spending more time on administrative tasks.
Residents with reduced teaching schedules reported feeling less emotionally exhausted and more satisfied with the patient care they provided. Indeed, there was a significant association between the level of emotional exhaustion and the level of satisfaction with patient care. Those responsible for hospital residency programs need to take these findings into consideration in order to maintain the well-being and work lives of their residents, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS11416).
See "Impact on duty-hour restriction on resident inpatient teaching," by Lindsay A. Mazotti, M.D., Arpana R. Vidyarthi, M.D., Robert M. Wachter, M.D., and others in the October 2009 Journal of Hospital Medicine 4(8), pp. 476-480.