title: Internal medicine and general surgery residents' attitudes about the ACGME duty hours regulations: a multicenter study.
abstract: OBJECTIVE
  To assess internal medicine and general surgery residents' attitudes about the effects of the Accreditation Council for Graduate Medical Education duty hours regulations on medical errors, quality of patient care, and residency experiences.
  
  
  METHODS
  In 2005, the authors surveyed 200 residents who trained both before and after duty hours reform at six residency programs (three internal medicine, three general surgery) at five academic medical centers in the United States. Residents' attitudes about the effects of the duty hours regulations on the quality of patient care, residency education, and quality of life were measured using a survey instrument containing 19 Likert scale questions on a scale of 1 to 5. Survey responses were compared using the Student's t-test.
  
  
  RESULTS
  The response rate was 80% (159 residents). Residents reported that whereas fatigue-related errors decreased slightly, errors related to reduced continuity of care significantly increased. Additionally, duty hours regulations somewhat decreased opportunities for formal education, bedside learning, and procedures, but there was no consensus that graduates would be less well trained after duty hours reform. Residents, particularly surgical trainees, reported improvements in quality of life and reduced burnout.
  
  
  CONCLUSIONS
  Residents in medicine and surgery had similar opinions about the effects of duty hours reform, including improved quality of life. However, resident opinions suggest that reduced fatigue-related errors have been offset by errors related to decreased continuity of care and that the quality of the educational experience may have declined. Quantifying the degree to which regulating duty hours affected errors related to discontinuity of care should be a focus of future research.
authors.affiliation: Division of General Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. jennifer.myers@uphs.upenn.edu
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Myers
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bellini
authors.forename: Jon B
authors.initials: JB
authors.lastname: Morris
authors.forename: Debra
authors.initials: D
authors.lastname: Graham
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
authors.forename: John R
authors.initials: JR
authors.lastname: Potts
authors.forename: Charles
authors.initials: C
authors.lastname: Weiner
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
mesh_terms: D001290:Attitude; D002055:Burnout, Professional / Q000517:prevention & control; D003625:Data Collection; D013502:General Surgery / Q000193:education*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000592:standards*; D019300:Medical Errors; D010561:Personnel Staffing and Scheduling; D011787:Quality of Health Care; D014481:United States