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Journal Article > Review
Duty hours restriction and their effect on resident education and academic departments: the American perspective.
Swide CE, Kirsch JR. Curr Opin Anaesthesiol. 2007;20:580-584.
This review assessed available data on the effects of the 2003 ACGME duty hour limitations and found that, while the educational environment and residents' quality of life improved, the effect on patient care remains unclear.
Journal Article > Study
Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac surgery.
Bruppacher HR, Alam SK, LeBlanc VR, et al. Anesthesiology. 2010;112:985-992.
The use of simulation is increasing in medical training, in part due to its success in other industries such as aviation. Although studies of simulation training have found positive effects on team communication and adherence to recommended processes, the effect of simulation on subsequent patient outcomes remains unclear. This study represents a significant advance in the simulation literature, as it found that anesthesia residents who underwent high-fidelity simulation training performed better at weaning patients from cardiopulmonary bypass than residents who underwent standard classroom-based training. Studies such as this, demonstrating that simulation training improves real-life clinical performance, strengthen the case for integrating simulation into medical education in an era of restricted duty hours.
Journal Article > Study
The impact of transitioning from a 24-hour to a 16-hour call model amongst a cohort of Canadian anesthesia residents at McMaster University—a survey study.
Sussman D, Paul JE. Adv Med Educ Pract. 2015;6:501-506.
Reducing shift length from 24 hours to 16 hours was well received by Canadian anesthesiology trainees, who felt the change improved their quality of life, reduced fatigue, and enhanced their education. This shift length reduction for interns was a core component of the 2011 duty hour reforms in the United States. Recent studies have shown that the regulations had no effect on patient-level clinical outcomes.
Journal Article > Commentary
Fatigue risk management: the impact of anesthesiology residents' work schedules on job performance and a review of potential countermeasures.
Wong LR, Flynn-Evans E, Ruskin KJ. Anesth Analg. 2018;126:1340-1348.
Duty hour reductions have been a controversial strategy to address resident fatigue. This commentary discusses guidelines for managing anesthesiology resident work hours and how the limits might affect training. The authors recommend other approaches to address fatigue such as naps, microbreaks, and scheduling and environmental adjustments.