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Residency Reforms Reduced Duty Hours, Increased Sleep

Residency Reforms Reduced Duty Hours, Increased Sleep

Research shows interns got more rest but were concerned about making a serious medical error

TUESDAY, March 26 (HealthDay News) -- Additional residency reforms implemented in 2011 have reduced duty hours and increased sleep duration, but with perceived reductions in quality of patient care, according to research published online March 25 in JAMA Internal Medicine.

Srijan Sen, M.D., Ph.D., from the University of Michigan in Ann Arbor, and colleagues compared duty hour requirements for 2,323 medical interns in 51 residency programs before and after the implementation of new duty hour reforms in 2011. The researchers found that duty hours fell from 67.0 to 64.3 hours per week, but with no change in hours slept, depressive symptoms, or well-being score. However, a higher percentage of interns was concerned about making a serious medical error.

Sanjay V. Desai, M.D., and colleagues from Johns Hopkins University in Baltimore, randomly assigned 43 interns in a three-month crossover design to a 2003-compliant model with 30-hour duty limits (control) or to one of two 2011-compliant models (every fifth night overnight call or a night float schedule), both with 16-hour duty limits. The researchers found that interns slept longer during the on-call period on the night float schedule, while interns slept longer during the post-call period on the fifth night overnight schedule.

"Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care," Desai and colleagues write.

One author from the first study disclosed being a consultant or advisory board member for several pharmaceutical companies.

Abstract - Sen (http://archinte.jamanetwork.com/article.aspx?articleid=1672284#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1672284 )Abstract - Desai (http://archinte.jamanetwork.com/article.aspx?articleid=1672279#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1672279 )