Duty hour limitations have been controversial due to inconclusive evidence regarding their impact on care outcomes. This review examined the effect of work hour restrictions on surgical residents. The authors found that duty hour restrictions have fallen short of their goals, discuss unintended consequences of the strategy that diminish safety, and call for amended policy solutions to address concerns.

According to this qualitative study at a single academic institution, staff surgeons and intensivists frequently exclude resident physicians from patient care conversations. Reasons included lack of trust, need for timely communication, and a perception that residents cannot adequately contribute to decision making. This finding has important implications for the integration of communication training during medical education.