Creating an educationally minded schedule: one approach to minimize the impact of duty hour standards on intern continuity clinic experience
To determine if implementing an educationally minded schedule utilizing consecutive night shifts can moderate the impact of the 2011 duty hour standards on education and patient continuity of care in longitudinal primary care experience (continuity clinic). A 14-month pre–post study was performed in continuity clinic with one supervising physician group and two intern groups. Surveys to assess attitudes and education were distributed to the supervising physicians and interns before and after the changes in duty hour standards. Intern groups’ schedules were reviewed for the number of regular and alternative day clinic (i.e. primary care experience on a different weekday) sessions and patient continuity of care. Fifteen supervising physicians and 51 interns participated (25 in 2011, 26 in 2012). Intern groups’ comfort when discussing patient issues, educational needs and teamwork perception did not differ. Supervising physicians’ understanding of learning needs and provision of feedback did not differ between groups. Supervising physicians indicated a greater ability to provide feedback and understand learning needs during regular continuity clinic sessions compared with alternative day clinics (all p < 0.05). No significant difference was detected between intern groups in the number of regularly scheduled continuity clinics, alternative day clinics or patient continuity of care. The 2011 duty hour standards required significant alterations to intern schedules, but educationally minded scheduling limited impact on education and patient continuity in care.
- McBurney PG, Moran CM, Ector WL, Quattlebaum TG, Darden PM. Time in continuity clinic as a predictor of continuity of care for pediatric residents. Pediatrics. 2004;114(4):1023–7. CrossRef
- Serwint JR, Feigelman S, Dumont-Driscoll M, Collins R, Zhan M, Kittredge D. Factors associated with resident satisfaction with their continuity experience. Ambul Pediatr. 2004;4(1):4–10. CrossRef
- Chaudhry S, Balwan S, Friendman KA. Moving forward in GME reform: a 4 + 1 model of resident ambulatory training. J Gen Intern Med. 2013;28(8):1100–4. CrossRef
- Perron NJ, Humair JP, Gaspoz JM. How to fulfill residents’ training needs and public service missions in outpatient general internal medicine? Swiss Med Wkly. 2012;142:w13620.
- Balmer D, Ruzek S, Ludwig S, Giardino A. Pediatric residents’ and continuity clinic supervising physicians’ perceptions of the effects of restricted work hours on their learning relationship. Ambul Pediatr. 2007;7(5):348–53. CrossRef
- Accreditation council for graduate medical education. Common program requirements. http://www.acgme.org/acwebsite/home/Common_Program_Requirements_07012011.pdf. Accessed 25 Mar 2011.
- Accreditation council on graduate medical education. ACGME program requirements for graduate medical education in pediatrics. http://www.acgme.org/acWebsite/downloads/RRC_progReq/320pr106.pdf. Accessed 25 Mar 2011.
- Burke AE, Rushton J, Guralnick S, Hicks P. Resident work duty hour requirements: medical educators’ perspectives. Acad Pediatr. 2010;10(6):369–71. CrossRef
- Drolet BC, Soh IY, Shultz PA, Fischer SA. A thematic review of resident commentary on duty hours and supervision regulations. J Grad Med Educ. 2012;4(4):454–9. CrossRef
- Antiel RM, Reed DA, Van Arendonk KJ, et al. Effects of duty hour restrictions on core competencies, education, quality of life, and burnout among general surgery interns. JAMA Surg. 2013;148(5):448–55. CrossRef
- Drolet BC, Khokhar MT, Fischer SA. The 2011 duty-hour requirements—a survey of residency program directors. N Engl J Med. 2013;368(8):694–7. CrossRef
- Creating an educationally minded schedule: one approach to minimize the impact of duty hour standards on intern continuity clinic experience
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Perspectives on Medical Education
Volume 3, Issue 5 , pp 391-398
- Cover Date
- Print ISSN
- Online ISSN
- Bohn Stafleu van Loghum
- Additional Links
- Continuity clinic
- Accreditation Council of Graduate Medical Education
- Duty hour standards
- Alternative day clinics
- Author Affiliations
- 1. Division of General and Community Paediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 2011, Cincinnati, OH, 45229, USA
- 2. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA