Effects of the 2011 duty hour restrictions on resident education and learning from patient admissions

Abstract

Objective: In July 2011, new duty hour limits for resident physicians were instituted to address concerns about the effects of sleep deprivation on patient care and trainee experience. We sought to evaluate potential educational impacts of these duty hour changes with regard to learning and frequency of attending interactions during patient admissions.

Methods: Forty-nine residents on general pediatric teams participated in a prospective observational cohort study. Intervention residents (n = 23) worked a shift-based schedule compliant with new requirements. Control residents (n = 26) were on call every fourth night and compliant with 2003 work hour limits. Faculty members were present 16 hours daily. Resident surveys assessed learning from admissions (frequency of attending interaction and perceived learning during admissions). Data were analyzed with generalized linear mixed models to account for multiple responses from each resident.

Results: Intervention interns and seniors were less likely to present admissions to faculty during morning rounds, but there were no differences between intervention and control groups in percentage of admissions discussed with faculty at any time. Perceived learning from admissions was not different between the 2 groups.

Conclusions: Faculty-resident interaction decreased during morning rounds; however, overall attending contact did not, suggesting inpatient teaching approaches must adapt to meet learners' needs throughout the workday.

Keywords: duty hour restrictions; graduate medical education; hospital medicine; resident education.