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Cited by 36Hospital Admissions and OutcomesSleep and Work-Related FatigueHealthcare professionals’ stress and burnout

Pilot trial of IOM duty hour recommendations in neurology residency programs: Unintended consequences

Schuh, L.A., Khan, M.A., Harle, H., Southerland, A.M., Hicks, W.J., Falchook, A., Schultz, L., Finney, G.R.·2011·Neurology
DOI 10.1212/wnl.0b013e31822c61c3
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Abstract

OBJECTIVE: To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. METHODS: This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. RESULTS: Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. CONCLUSIONS: The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

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Crossref · 10.1212/wnl.0b013e31822c61c3

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  • Organizational interventions showed no statistically significant association with any burnout domain (EE, DP, PA).

    “In organizational intervention studies [44, 45, 47–49, 73, 76], pooling of post-intervention intervention Cohen’s d SMD yielded non-statistically significant resulted in all outcomes, EE (-0.22, 95% CI -0.47 to 0.04, p = 0.10, I2 = 62.6%) (Fig. 3A), DP (-0.15, 95% CI -0.38 to 0.08, p = 0.21, I2 = 53.0%) (Fig. 3B), and PA (0.12, 95% CI -0.01 to 0.25, p = 0.07; I2 = 0%) (Fig. 3C).”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [73]

  • In the organizational work-hour intervention subgroup, there was no significant post-intervention effect across all outcome domains: EE -0.20 (95% CI -0.58 to 0.17, p = 0.29, I2 = 67.1%), DP -0.16 (95% CI -0.48 to 0.16, p = 0.33, I2 = 55.8%), and PA 0.04 (95% CI -0.12 to 0.20, p = 0.60, I2 = 0%).

    “Subgroup analyses revealed no post-intervention Cohen’s d SMD in work-hour interventions [44, 45, 47, 73, 76] across all outcome domains: EE (-0.20, 95% CI -0.58 to 0.17, p = 0.29, I2 = 67.1%), DP (-0.16, 95% CI -0.48 to 0.16, p = 0.33, I2 = 55.8%), and PA (0.04, 95% CI -0.12 to 0.20, p = 0.60, I2 = 0%).”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [73]

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Authors
Schuh, L. A., Khan, M. A., Harle, H., Southerland, A. M., Hicks, W. J., Falchook, A., Schultz, L., & Finney, G. R.
Affiliations
University of Virginia Health System (US)
ORCID
Venue
Neurology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-08-30
Volume
77
Issue
9
Pages
883-887
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
DOI
10.1212/wnl.0b013e31822c61c3
OpenAlex
W2038152899
Cited by
36
References
8
Citations by year
2024: 2 · 2023: 1 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 5 · 2013: 6 · 2012: 3
FWCI
5.88
Type
journal article
Language
en
Open access
closed
Locations
  • Neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
neurology residency, resident burnout, quality of life, faculty satisfaction, continuity of care, patient handover
MeSH terms
Adult, Female, Humans, Internship and Residency, Male, Neurology, Personnel Staffing and Scheduling, Pilot Projects, Prospective Studies, Sleep Deprivation, United States, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Workload

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