Duty Hour Recommendations and Implications for Meeting the ACGME Core Competencies: Views of Residency Directors
Duty Hour Recommendations and Implications for Meeting the ACGME Core Competencies: Views of Residency Directors
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DOI：
10.4065/mcp.2010.0635
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发表时间：
2011-03-01
影响因子：
8.9
通讯作者：
Reed, Darcy A.
中科院分区：
文献类型：
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作者：
Antiel, Ryan M.;Thompson, Scott M.;Reed, Darcy A.
目的：描述住院医师项目主任对2010年值班时间建议对研究生医学教育6项核心能力的影响的看法。方法：2010年7月8日至7月20日，在2010年研究生医学教育认证委员会（ACGME）的工作时间建议公布后，美国内科、儿科和普外科住院医师项目主任通过电子邮件进行了一项调查。主任们被要求评价新建议对6项委员会核心能力的影响，以及对住院病人护理的连续性和住院医生疲劳的影响。结果：在719名符合条件的项目主管中，464名（65%）做出了回应。大多数项目主管认为，新的ACGME建议将降低住院医生与住院病人的连续性（404/464[87%]），不会改变（303/464[65%]）或增加（26/464[6%]）住院医生的疲劳。此外，大多数项目主管（249-363/464[53%-78%]）认为，新的值班时间限制将降低住院医生在6个核心领域中的5个领域培养能力的能力。外科主任比内科主任更有可能相信ACGME的建议会降低住院医生的病人护理能力（优势比[OR]， 3.9； 95%置信区间[CI]， 2.5-6.3）、医学知识（OR, 1.9; 95% Cl, 1.2-3.2）、基于实践的学习和改进（OR, 2.7; 95% Cl, 1.74.4）、人际和沟通技巧（OR, 1.9; 95% Cl, 1.2-3.0）和专业精神（OR, 2.5; 95% Cl, 1.54.0）。结论：住院医师项目主任对ACGME值班时间建议的反应表明，面对日益增加的值班时间标准和法规，他们对培养合格的下一代未来医生有明显的关注。
OBJECTIVE: To describe the views of residency program directors regarding the effect of the 2010 duty hour recommendations on the 6 core competencies of graduate medical education.METHODS: US residency program directors in internal medicine, pediatrics, and general surgery were e-mailed a survey from July 8 through July 20, 2010, after the 2010 Accreditation Council for Graduate Medical Education (ACGME) duty hour recommendations were published. Directors were asked to rate the implications of the new recommendations for the 6 ACGME core competencies as well as for continuity of inpatient care and resident fatigue.RESULTS: Of 719 eligible program directors, 464 (65%) responded. Most program directors believe that the new ACGME recommendations will decrease residents' continuity with hospitalized patients (404/464 [87%]) and will not change (303/464 [65%]) or will increase (26/464 [6%]) resident fatigue. Additionally, most program directors (249-363/464 [53%-78%]) believe that the new duty hour restrictions will decrease residents' ability to develop competency in 5 of the 6 core areas. Surgery directors were more likely than internal medicine directors to believe that the ACGME recommendations will decrease residents' competency in patient care (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.5-6.3), medical knowledge (OR, 1.9; 95% Cl, 1.2-3.2), practice-based learning and improvement (OR, 2.7; 95% Cl, 1.74.4), interpersonal and communication skills (OR, 1.9; 95% Cl, 1.2-3.0), and professionalism (OR, 2.5; 95% Cl, 1.54.0).CONCLUSION: Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation.