Myths and Realities of the 80-Hour Work Week

Paul J. Schenarts MD , Kimberly D. Anderson Schenarts PhD , Michael F. Rotondo MD
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引用次数: 40

Abstract

Background

Myths are so ingrained into cultural traditions that emotion frequently overshadows a rational evaluation of the facts. The reduction in resident work hours has resulted in the formation of several myths. The purpose of this review is to examine the published data on resident work hours to separate out myth from reality.

Methods

An electronic database was searched for publications related to resident training, work-hours, continuity of care, sleep deprivation, quality of life, patient safety, clinical/operative experience, faculty work hours, and surgical education.

Results

Sleep deprivation has been shown to be harmful, and residents played a role in advocating for work-hour limits. Surgical residents have seen a less dramatic improvement in quality of life compared with other disciplines. Work-hour reductions have decreased participation in clinic but have not resulted in a significant decline in clinical or operative exposure. Limiting resident work hours will unlikely result in a decrease health-care cost. Reduction in resident work hours has not resulted in an improvement or deterioration in patient outcome. Reduction of work hours has not increased faculty work hours nor made surgery a more attractive career choice.

Conclusions

Despite strongly held opinions, resident work-hour reduction has resulted in little significant change in lifestyle, clinical exposure, patient well-being, faculty work hours, or medical student recruitment.

《每周80小时工作制的神话与现实
神话在文化传统中是如此根深蒂固,以至于情感常常掩盖了对事实的理性评估。居民工作时间的减少导致了几个神话的形成。本综述的目的是检验已公布的关于住院医生工作时间的数据,以区分神话和现实。方法在电子数据库中检索与住院医师培训、工作时间、护理连续性、睡眠剥夺、生活质量、患者安全、临床/手术经验、教员工作时间和外科教育相关的出版物。结果睡眠不足已被证明是有害的,住院医生在倡导限制工作时间方面发挥了作用。与其他学科相比,外科住院医师在生活质量方面的改善并不明显。工作时间的减少减少了临床参与,但并没有导致临床或手术暴露的显著下降。限制住院医生的工作时间不太可能降低保健费用。住院医师工作时间的减少并没有导致患者预后的改善或恶化。工作时间的减少并没有增加教师的工作时间,也没有使外科成为一个更有吸引力的职业选择。结论:尽管人们持有强烈的意见,但住院医生工作时间的减少并没有导致生活方式、临床暴露、患者健康、教师工作时间或医学生招聘方面的显著变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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