Effect of the 30-Hour Work Limit on Resident Experience and Education

Brent S. Izu, R. Michael Johnson, Paula M. Termuhlen, Alex G. Little

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Purpose: To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. Methods: In September 2006, we administered a 10-item Likert scale survey to 41 general surgery residents to assess their experience with the 30-hour work restriction. We also reviewed the operative reports from the busiest general surgery service in April 2003 and April 2005 to assess surgical participation before and after the 30-hour restriction. Results: Twenty-three (56%) residents reported missed operations each month because of the 30-hour restriction. Thirty-four (83%) reported occasions where participating in an operation would require only an additional 1-4 hours. Thirty-six (88%) residents reported a better educational experience when operating on patients whom they had evaluated and a preference to operate on patients whom they had evaluated. The operative log review revealed that in April 2003, the resident assigned to the service participated in 47 out of 134 (35%) total operations and 11 out of 30 (37%) operations beginning after noon. In April 2005, the resident assigned to the service participated in 49 out of 109 (45%) total operations and 20 out of 45 (44%) of the operations beginning after noon. Conclusion: The difference in the amount of operations involving resident participation before and after the 30-hour restriction, including afternoon cases that would be most affected by the work restriction, was minimal. However, we identified occasions when the 30-hour work restriction could be extended to provide continuity of care and a better educational operative experience while maintaining weekly duty hours within the approved limit. Extensions beyond the 30 hours should be limited to providing unique and comprehensive experiences for residents where the additional time or episodes would not cause resident fatigue.

Original languageEnglish (US)
Pages (from-to)361-364
Number of pages4
JournalJournal of surgical education
Volume64
Issue number6
DOIs
StatePublished - Nov 1 2007

Fingerprint

Continuity of Patient Care
resident
Education
education
experience
Fatigue
surgery
participation
continuity
fatigue
cause
Surveys and Questionnaires

Keywords

  • Medical Knowledge
  • Patient Care
  • Practice Based Learning and Improvement
  • Professionalism
  • continuity of patient care
  • internship and residency
  • patient care
  • quality of life
  • surgery/education

Cite this

Effect of the 30-Hour Work Limit on Resident Experience and Education. / Izu, Brent S.; Johnson, R. Michael; Termuhlen, Paula M.; Little, Alex G.

In: Journal of surgical education, Vol. 64, No. 6, 01.11.2007, p. 361-364.

Research output: Contribution to journalReview article

Izu, Brent S. ; Johnson, R. Michael ; Termuhlen, Paula M. ; Little, Alex G. / Effect of the 30-Hour Work Limit on Resident Experience and Education. In: Journal of surgical education. 2007 ; Vol. 64, No. 6. pp. 361-364.
@article{51c9c11287584ce9a82228ee3c03a9ca,
title = "Effect of the 30-Hour Work Limit on Resident Experience and Education",
abstract = "Purpose: To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. Methods: In September 2006, we administered a 10-item Likert scale survey to 41 general surgery residents to assess their experience with the 30-hour work restriction. We also reviewed the operative reports from the busiest general surgery service in April 2003 and April 2005 to assess surgical participation before and after the 30-hour restriction. Results: Twenty-three (56{\%}) residents reported missed operations each month because of the 30-hour restriction. Thirty-four (83{\%}) reported occasions where participating in an operation would require only an additional 1-4 hours. Thirty-six (88{\%}) residents reported a better educational experience when operating on patients whom they had evaluated and a preference to operate on patients whom they had evaluated. The operative log review revealed that in April 2003, the resident assigned to the service participated in 47 out of 134 (35{\%}) total operations and 11 out of 30 (37{\%}) operations beginning after noon. In April 2005, the resident assigned to the service participated in 49 out of 109 (45{\%}) total operations and 20 out of 45 (44{\%}) of the operations beginning after noon. Conclusion: The difference in the amount of operations involving resident participation before and after the 30-hour restriction, including afternoon cases that would be most affected by the work restriction, was minimal. However, we identified occasions when the 30-hour work restriction could be extended to provide continuity of care and a better educational operative experience while maintaining weekly duty hours within the approved limit. Extensions beyond the 30 hours should be limited to providing unique and comprehensive experiences for residents where the additional time or episodes would not cause resident fatigue.",
keywords = "Medical Knowledge, Patient Care, Practice Based Learning and Improvement, Professionalism, continuity of patient care, internship and residency, patient care, quality of life, surgery/education",
author = "Izu, {Brent S.} and Johnson, {R. Michael} and Termuhlen, {Paula M.} and Little, {Alex G.}",
year = "2007",
month = "11",
day = "1",
doi = "10.1016/j.jsurg.2007.08.006",
language = "English (US)",
volume = "64",
pages = "361--364",
journal = "Journal of Surgical Education",
issn = "1931-7204",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Effect of the 30-Hour Work Limit on Resident Experience and Education

AU - Izu, Brent S.

AU - Johnson, R. Michael

AU - Termuhlen, Paula M.

AU - Little, Alex G.

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Purpose: To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. Methods: In September 2006, we administered a 10-item Likert scale survey to 41 general surgery residents to assess their experience with the 30-hour work restriction. We also reviewed the operative reports from the busiest general surgery service in April 2003 and April 2005 to assess surgical participation before and after the 30-hour restriction. Results: Twenty-three (56%) residents reported missed operations each month because of the 30-hour restriction. Thirty-four (83%) reported occasions where participating in an operation would require only an additional 1-4 hours. Thirty-six (88%) residents reported a better educational experience when operating on patients whom they had evaluated and a preference to operate on patients whom they had evaluated. The operative log review revealed that in April 2003, the resident assigned to the service participated in 47 out of 134 (35%) total operations and 11 out of 30 (37%) operations beginning after noon. In April 2005, the resident assigned to the service participated in 49 out of 109 (45%) total operations and 20 out of 45 (44%) of the operations beginning after noon. Conclusion: The difference in the amount of operations involving resident participation before and after the 30-hour restriction, including afternoon cases that would be most affected by the work restriction, was minimal. However, we identified occasions when the 30-hour work restriction could be extended to provide continuity of care and a better educational operative experience while maintaining weekly duty hours within the approved limit. Extensions beyond the 30 hours should be limited to providing unique and comprehensive experiences for residents where the additional time or episodes would not cause resident fatigue.

AB - Purpose: To evaluate the effect of the 30-hour restriction on resident operative participation and assess whether the 30-hour restriction can be extended in certain cases to enhance educational experience and continuity of care without being detrimental to the 80-hour limit. Methods: In September 2006, we administered a 10-item Likert scale survey to 41 general surgery residents to assess their experience with the 30-hour work restriction. We also reviewed the operative reports from the busiest general surgery service in April 2003 and April 2005 to assess surgical participation before and after the 30-hour restriction. Results: Twenty-three (56%) residents reported missed operations each month because of the 30-hour restriction. Thirty-four (83%) reported occasions where participating in an operation would require only an additional 1-4 hours. Thirty-six (88%) residents reported a better educational experience when operating on patients whom they had evaluated and a preference to operate on patients whom they had evaluated. The operative log review revealed that in April 2003, the resident assigned to the service participated in 47 out of 134 (35%) total operations and 11 out of 30 (37%) operations beginning after noon. In April 2005, the resident assigned to the service participated in 49 out of 109 (45%) total operations and 20 out of 45 (44%) of the operations beginning after noon. Conclusion: The difference in the amount of operations involving resident participation before and after the 30-hour restriction, including afternoon cases that would be most affected by the work restriction, was minimal. However, we identified occasions when the 30-hour work restriction could be extended to provide continuity of care and a better educational operative experience while maintaining weekly duty hours within the approved limit. Extensions beyond the 30 hours should be limited to providing unique and comprehensive experiences for residents where the additional time or episodes would not cause resident fatigue.

KW - Medical Knowledge

KW - Patient Care

KW - Practice Based Learning and Improvement

KW - Professionalism

KW - continuity of patient care

KW - internship and residency

KW - patient care

KW - quality of life

KW - surgery/education

UR - http://www.scopus.com/inward/record.url?scp=36549073672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36549073672&partnerID=8YFLogxK

U2 - 10.1016/j.jsurg.2007.08.006

DO - 10.1016/j.jsurg.2007.08.006

M3 - Review article

C2 - 18063270

AN - SCOPUS:36549073672

VL - 64

SP - 361

EP - 364

JO - Journal of Surgical Education

JF - Journal of Surgical Education

SN - 1931-7204

IS - 6

ER -