title: Effects of the 2011 duty hour restrictions on resident education and learning from patient admissions.
abstract: OBJECTIVE
  In July 2011, new duty hour limits for resident physicians were instituted to address concerns about the effects of sleep deprivation on patient care and trainee experience. We sought to evaluate potential educational impacts of these duty hour changes with regard to learning and frequency of attending interactions during patient admissions.
  
  
  METHODS
  Forty-nine residents on general pediatric teams participated in a prospective observational cohort study. Intervention residents (n = 23) worked a shift-based schedule compliant with new requirements. Control residents (n = 26) were on call every fourth night and compliant with 2003 work hour limits. Faculty members were present 16 hours daily. Resident surveys assessed learning from admissions (frequency of attending interaction and perceived learning during admissions). Data were analyzed with generalized linear mixed models to account for multiple responses from each resident.
  
  
  RESULTS
  Intervention interns and seniors were less likely to present admissions to faculty during morning rounds, but there were no differences between intervention and control groups in percentage of admissions discussed with faculty at any time. Perceived learning from admissions was not different between the 2 groups.
  
  
  CONCLUSIONS
  Faculty-resident interaction decreased during morning rounds; however, overall attending contact did not, suggesting inpatient teaching approaches must adapt to meet learners' needs throughout the workday.
authors.affiliation: Division of Hospital Medicine James M. Anderson Center for Health Systems Excellence, and katherine.auger@cchmc.org.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Auger
authors.affiliation: Division of Hospital Medicine.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Jerardi
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Sucharew
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Connie
authors.initials: C
authors.lastname: Yau
authors.affiliation: Division of Hospital Medicine.
authors.forename: Ndidi
authors.initials: N
authors.lastname: Unaka
authors.affiliation: Division of Hospital Medicine.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Simmons
mesh_terms: D002983:Clinical Competence; D005180:Faculty, Medical; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007858:Learning; D010343:Patient Admission; D010372:Pediatrics / Q000193:education*; D010561:Personnel Staffing and Scheduling; D056164:Teaching Rounds / Q000706:statistics & numerical data; D014940:Work Schedule Tolerance; D016526:Workload / Q000706:statistics & numerical data
keywords: duty hour restrictions; graduate medical education; hospital medicine; resident education