Residents whose 80-hour work week conforms to new duty-hour requirements report less fatigue interfering with their care of patients, according to researchers from Johns 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 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 falling asleep 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," says senior author Julia McMillan, M.D., professor of pediatrics at Johns Hopkins Children's Center.
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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Contact: Katerina Pesheva
Johns Hopkins Medical Institutions
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