… Med … Disruptive and unprofessional behavior results in a poor culture of safety and may contribute to adverse … acknowledge that study of this area is impaired by lack of a standard definition and measurement strategy for unprofessional behavior and by a poor understanding of the relationship between …

Current studies suggest that the ACGME duty hours reform in 2011 did not substantially affect patient outcomes. Consistent with prior work, this retrospective cohort study found no differences in primary outcomes such as mortality. However, the authors suggest that future studies examine other quality metrics that may have changed after the duty-hours reform.

The implementation of resident duty hours over the past decade has been controversial. The New England Journal of Medicine hosted a roundtable discussion exploring the effects of duty hour regulations on residency training. Moderated by Dr. Debra Weinstein, the discussion featured Dr. Vineet Arora, Dr. Eileen Reynolds, and surgical resident Dr. Brian Drolet as panelists. The discussants noted the evidence for patient safety after duty-hour restrictions has not been as robust as people had predicted. They also focused on the increase in supervision, changes in sense of professionalism, and challenges of handoffs that have followed duty hours. Accompanying the video are two perspective articles written by physicians from different generations describing the benefits and drawbacks of their overnight experiences. A recent AHRQ WebM&M perspective and interview also discussed the potential impact of resident duty hours on patient safety.

This survey of residency program directors in the United States found overall approval of almost all 2011 ACGME work-hour regulations, except for the rule limiting interns to 16-hour shifts. Respondents reported that work-hour restrictions negatively affect resident education and continuity of care, and almost half of those surveyed described duty-hours violations.

… J Med … This survey of residency program directors found a mixed reaction to the 2011 duty hour regulations . Although …

Over the past decade, increasing duty-hour regulations for resident physicians have been motivated by efforts to improve patient care, resident education, and resident quality of life. Despite mixed results in achieving those goals, the 2011 regulations extended the work hour limits further and added a significant cost burden to teaching institutions in covering provider gaps. This survey study captured more than 6200 responses from a diverse group of resident physicians to assess the impact of the newest regulations. Overall, nearly half the residents disapprove of the regulations, and nearly 60% report that their hours worked are unchanged compared to last year. Other notable findings included that 43% reported no change in the quality of care, more than half believed preparation for more senior roles was worse, and only 16% believed education was improved. Not surprisingly, 72% reported increased handoffs, and only interns reported improvements in their quality of life. The authors conclude that a one-size-fits-all approach that comes with such regulations may not meet the needs of all trainees or training environments.

… been mixed , including from this study, which surveyed a nationwide sample of residents. Whereas residents felt the …