title: Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care.
abstract: BACKGROUND
  Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains.
  
  
  METHODS
  Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t-test for paired samples.
  
  
  RESULTS
  Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions.
  
  
  CONCLUSIONS
  Senior residents in a Canadian internal medicine training program perceived significant benefits in medical education experience, ability to deliver healthcare, and resident wellness after implementation of duty hour reform.
authors.affiliation: Division of Cardiology, Department of Medicine, Dalhousie University & Capital Health, QEII - Halifax Infirmary Site, 1796 Summer Street, B3H 3A6, Halifax, NS, Canada. andrewmoeller@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Moeller
authors.affiliation: Division of Cardiology, Department of Medicine, Dalhousie University & Capital Health, QEII - Halifax Infirmary Site, 1796 Summer Street, B3H 3A6, Halifax, NS, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Webber
authors.affiliation: Department Medicine, Dalhousie University & Capital Health, QEII Health Sciences Centre, VG Site, 1276 South Park St, Halifax, NS, B3H 2Y9, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Epstein
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada / Q000453:epidemiology; D003695:Delivery of Health Care / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D007588:Job Satisfaction; D061214:Patient Safety; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D012892:Sleep Deprivation / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D014940:Work Schedule Tolerance / Q000502:physiology / Q000523:psychology*; D016526:Workload
keywords: Curriculum; Post-graduate; Quantitative research; Residency; Resident duty hour modification