Medical Residents Divided on Work-Hour Changes
Asked about the overall effect of the proposed changes on education, far more residents anticipated a negative effect (48 percent) than a positive one (26 percent).
Specifically, they offered resoundingly negative views about the impact on residents' education, experience, and fund of knowledge (54 percent negative, 24 percent positive); and residents' preparation for more senior roles (63 percent negative, 13 percent positive).
Sonia Lazreg, a health justice fellow at American Medical Student Association, thinks that residents need more education about the body of knowledge around work hours.
"We don't know how well educated residents are" on the work hours issue, she explains, noting that there's considerable evidence to support the changes. (AMSA has advocated for work-hour changes.)
For example, Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, a December 2008 report from the IOM, called for changing residents' workloads and duty hours to protect patients against fatigue-related errors and to enhance the learning environment for doctors in training.
Moreover, even though 72 percent of the survey respondents said they were familiar with the proposed changes?and all received a short summary—Lazreg wonders how well they understand them. She's not surprised by the findings.
While she questions the survey's significance, she's most focused on education. And part of that requires healthcare leaders to make sure that residents and other staff members understand the changes—and the evidence behind them. It would, she says, be far more interesting to conduct the survey again once the residents understand both the changes and the evidence.
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