Residents report less fatigue, better care under
By Katerina Pesheva
Residents whose 80-hour work week conforms to new duty-hour
requirements report less fatigue interfering with their
care of patients, according researchers from
Hopkins Children's Center. The 80-hour-week mandate
went into effect nationwide in 2003, but little research
has been done to evaluate the impact on residents.
In the three-year study, researchers studied 185 pediatric
first-, second-and third-year residents at Johns Hopkins,
asking them to report their perceptions of the effect of
fatigue on clinical care, education and personal life.
In addition to less fatigue, first-and second-year
residents who worked 80 hours reported that decreased
fatigue improved the completeness of the care they
delivered. Reduced work hours had the most pronounced
effect among first-year residents, who reported less
fatigue interfering with patient care, communication,
ability to perform procedures and mathematical
calculations, and staying alert during conferences.
"Most of these findings do not come as a surprise to us,
but one thing that was quite surprising was how much more
impact the benefits of reduced work hours had on interns
vs. second-and third-year residents," said senior author
Julia McMillan, professor of pediatrics.
Investigators caution that residents reported
self-perceptions not objective outcome measures. In
addition, researchers warn that their findings cannot
necessarily be generalized nationally and that future
studies should measure whether this shift in perceptions
carries on over time.
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