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residents work hour restriction

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https://www.readbyqxmd.com/read/29141629/the-potential-impact-of-brexit-and-immigration-policies-on-the-gp-workforce-in-england-a-cross-sectional-observational-study-of-gp-qualification-region-and-the-characteristics-of-the-areas-and-population-they-served-in-september-2016
#1
Aneez Esmail, Maria Panagioti, Evangelos Kontopantelis
BACKGROUND: The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve...
November 16, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29073389/impact-of-extended-duty-hours-on-medical-trainees
#2
Pnina Weiss, Meir Kryger, Melissa Knauert
Many studies on resident physicians have demonstrated that extended work hours are associated with a negative impact on well-being, education, and patient care. However, the relationship between the work schedule and the degree of impairment remains unclear. In recent years, because of concerns for patient safety, national minimum standards for duty hours have been instituted (2003) and revised (2011). These changes were based on studies of the effects of sleep deprivation on human performance and specifically on the effect of extended shifts on resident performance...
December 2016: Sleep Health
https://www.readbyqxmd.com/read/29055898/night-time-communication-at-stanford-university-hospital-perceptions-reality-and-solutions
#3
Andrew Jordan Sun, Libo Wang, Minjoung Go, Zac Eggers, Raymond Deng, Paul Maggio, Lisa Shieh
BACKGROUND: Resident work hour restrictions have led to the creation of the 'night float' to care for the patients of multiple primary teams after hours. These residents are often inundated with acute issues in the numerous patients they cover and are less able to address non-urgent issues that arise at night. Further, non-urgent pages may contribute to physician alarm fatigue and negatively impact patient outcomes. OBJECTIVE: To delineate the burden of non-urgent paging at night and propose solutions...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28843764/more-learning-in-less-time-optimizing-the-resident-educational-experience-with-limited-clinical-and-educational-work-hours
#4
Cara L Sedney, Eleni Spirou, Joseph L Voelker, Charles L Rosen
OBJECTIVE: Resident education in the United States and elsewhere has undergone significant changes in recent years owing to work hour restrictions, requiring didactics to fit within a limited schedule, while being increasingly effective at accomplishing educational goals. METHODS: A single small program experience in improving the didactic experience of residents is described. RESULTS: Focused mentorship, curricula for intangibles, asynchronous education, and independent curricula all are useful tools in resident education...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28827181/keeping-residents-in-the-dark-do-night-float-rotations-provide-a-valuable-educational-experience
#5
Alessandra Landmann, Heidi Mahnken, Mara B Antonoff, SuAnn White, Arpit Patel, Aaron M Scifres, Jason S Lees
OBJECTIVE: To qualify and characterize resident overnight activity. DESIGN: A prospective 3-phase study was conducted of surgical residents with attention to activities performed on the overnight rotation: needs assessment, direct observation of activities, and feedback. SETTING: This study was conducted at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. This is both a tertiary referral center and the only American College of Surgeons (ACS) verified level 1 trauma center in the state...
August 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28760500/status-of-resident-attrition-from-surgical-residency-in-the-past-present-and-future-outlook
#6
Faris Shweikeh, Alexander C Schwed, Chiu-Hsieh Hsu, Valentine N Nfonsam
OBJECTIVE: To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN: A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statistically significant influencing factors were the main measures and outcomes. SELECTION: All English language articles that described attrition from a general surgery residency were included...
July 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28746075/fatigue-in-residency-education-understanding-the-influence-of-work-hours-regulations-in-europe
#7
Taryn S Taylor, Pim W Teunissen, Tim Dornan, Lorelei Lingard
PURPOSE: Although one proposed solution to the problem of fatigued medical trainees is the implementation of work hours regulations, concerns about the effectiveness of these regulations are growing. Canada remains one of the few Western jurisdictions without legislated regulation. Recent research suggests that fatigue is a complex social construct, rather than simply a lack of sleep; thus, the authors explored how regulations and fatigue are understood in countries with established work hours frameworks to better inform other jurisdictions looking to address trainee fatigue...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28744881/new-common-program-requirements-for-the-resident-physician-workforce-and-the-omission-of-strategic-napping-a-missed-opportunity
#8
Michelle M Shnayder, Joan E St Onge, Alberto J Caban-Martinez
OBJECTIVES: Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. METHODS: We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations...
July 26, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28720087/resident-perceptions-of-the-impact-of-duty-hour-restrictions-on-resident-attending-interactions-an-exploratory-study
#9
Kristen A Gerjevic, Marcy E Rosenbaum, Manish Suneja
BACKGROUND: The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations...
July 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28673883/microsurgical-performance-after-sleep-interruption-a-neurotouch-simulator-study
#10
Alexander Micko, Karoline Knopp, Engelbert Knosp, Stefan Wolfsberger
OBJECTIVE: In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. METHODS: Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test)...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28651904/community-based-distribution-of-misoprostol-for-early-abortion-evaluation-of-a-program-along-the-thailand-burma-border
#11
Angel M Foster, Grady Arnott, Margaret Hobstetter
BACKGROUND: Although abortion is legal in Thailand for a number of indications, women from Burma residing in Thailand are rarely able to access safe services. We evaluated the outcomes of a community-based distribution program that provides migrant, refugee, and cross-border women from Burma with evidence-based information about and access to misoprostol for early pregnancy termination. METHODS: After determination of eligibility based on self-report and counseling, trained Network members instructed women to vaginally administer two 800-mcg doses of misoprostol 24 h apart and a third dose one week later, if needed...
June 23, 2017: Contraception
https://www.readbyqxmd.com/read/28638506/efficacy-of-interventions-to-reduce-resident-physician-burnout-a-systematic-review
#12
REVIEW
Kiran R Busireddy, Jonathan A Miller, Kathleen Ellison, Vicky Ren, Rehan Qayyum, Mukta Panda
BACKGROUND: Studies report high burnout prevalence among resident physicians, with little consensus on methods to effectively reduce it. OBJECTIVE: This systematic literature review explores the efficacy of interventions in reducing resident burnout. METHODS: PubMed, Embase, and Web of Science were searched using these key words: burnout and resident, intern, or residency. We excluded review articles, editorials, letters, and non-English-language articles...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28633175/the-marshall-family-medicine-residency-twintern-schedule-the-impact-of-an-innovative-hospital-coverage-scheme-on-resident-fatigue
#13
Adam Franks, Stephen M Petrany, Sydnee McElroy, Adam Alley
BACKGROUND AND OBJECTIVES: Work hour restriction has strained the balance between resident service and education. Night Float (NF) rotations are a popular answer to managing this balance but weakens continuity, an essential tenant of family medicine. An innovative short call system for Marshall University's Family Medicine Hospital Service (FMHS), the twINTERN call model, was created in response. We studied the impact of this approach on resident fatigue. METHODS: Anonymous surveys assessed fatigue of the Marshall University's 2013-2014 Family Medicine intern resident class while on NF rotations (ICU, Pediatrics and Surgery) and the twINTERN call...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#14
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy D Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28439356/impact-of-the-2003-acgme-resident-duty-hour-reform-on-hospital-acquired-conditions-a-national-retrospective-analysis
#15
Timothy Wen, Frank J Attenello, Steven Y Cen, Alexander A Khalessi, May Kim-Tenser, Nerses Sanossian, Steven L Giannotta, Arun P Amar, William J Mack
BACKGROUND: The Accreditation Council for Graduate Medical Education reforms in 2003 instituted an 80-hour weekly limit for resident physicians. Critics argue that these restrictions have increased handoffs among residents and the potential for a decline in patient safety. "Never events" hospital-acquired conditions (HACs) are a set of preventable events used as a quality metric in hospital safety analyses. OBJECTIVE: This analysis evaluated post-work hour reform effects on HAC incidence for US hospital inpatients, using the National Inpatient Sample...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28375898/virtual-reality-compared-with-bench-top-simulation-in-the-acquisition-of-arthroscopic-skill-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Daniel Banaszek, Daniel You, Justues Chang, Michael Pickell, Daniel Hesse, Wilma M Hopman, Daniel Borschneck, Davide Bardana
BACKGROUND: Work-hour restrictions as set forth by the Accreditation Council for Graduate Medical Education (ACGME) and other governing bodies have forced training programs to seek out new learning tools to accelerate acquisition of both medical skills and knowledge. As a result, competency-based training has become an important part of residency training. The purpose of this study was to directly compare arthroscopic skill acquisition in both high-fidelity and low-fidelity simulator models and to assess skill transfer from either modality to a cadaveric specimen, simulating intraoperative conditions...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28375523/how-the-acgme-work-hour-restrictions-have-affected-orthopedic-residents
#17
EDITORIAL
Bryan M Saltzman, Jonathan M Frank
No abstract text is available yet for this article.
January 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#18
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28329124/sleep-and-alertness-in-medical-interns-and-residents-an-observational-study-on-the-role-of-extended-shifts
#19
Mathias Basner, David F Dinges, Judy A Shea, Dylan S Small, Jingsan Zhu, Laurie Norton, Adrian J Ecker, Cristina Novak, Lisa M Bellini, Kevin G Volpp
Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy...
April 1, 2017: Sleep
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#20
REVIEW
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
June 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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