Effects of Accreditation Council for Graduate Medical Education work hour restrictions on medical student experience

L James Nixon, Bradley J Benson, Tyson B Rogers, Brian T Sick, Wesley J Miller
Journal of General Internal Medicine 2007, 22 (7): 937-41

BACKGROUND: Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education.

OBJECTIVE: Our objective was to determine the effects of resident work hour restrictions on medical student education.

DESIGN: We compared student responses pre work hour restrictions with those completed post work hour restrictions.

PARTICIPANTS: Students on required Internal Medicine, Surgery, and Pediatric clerkships at the University of Minnesota.

MEASUREMENTS: Two thousand eight hundred twenty-five student responses on end-of-clerkship surveys.

RESULTS: Students reported 1.6 more hours per week of teaching by residents (95%CI 0.8-2.6) in the post work hours era. Students' ratings of the overall quality of their teaching on the ward did not change appreciably, 0.05 points' decline on a 5-point scale (P = .05). Like the residents, students worked fewer hours per week (avg. 1.5 hours less, 95%CI 0.4-2.6). There was no change in quality or quantity of attending teaching, students' relationships with their patients, or the overall value of the clerkships.

CONCLUSIONS: Whereas resident duty hour restrictions at our institution have had minimal effect on students' ratings of the overall teaching quality, they do report being taught more by their residents. This may be a factor of decreased resident fatigue or an increased sense of well-being; but more study is needed to clarify the causes of our observations.

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