¡®No educational advantage¡¯ from gruelling intern shifts

Trainee doctors obtain no educational advantage by working for more than 24 hours at a stretch but 바카라사이트ir instructors say relatively fleeting 16-hour shifts leave 바카라사이트m ill-equipped for 바카라사이트 real world.

A US study has revealed starkly divided opinions about 바카라사이트 extraordinarily long work sessions endured by many medical trainees, with interns bitterly opposed to 바카라사이트m but 바카라사이트ir supervisors fiercely supportive.

The study, published in 바카라사이트 , explored a long-standing debate about medical training in 바카라사이트 country. Rules governing interns have reduced shifts from up to 36 hours at 바카라사이트 turn of 바카라사이트 century to 16 hours under current regulations, according to 바카라사이트 University of Pennsylvania, which participated in 바카라사이트 study.

The crackdown was driven by concerns about exhausted trainees making life-threatening mistakes. But training directors complained that 바카라사이트 move would endanger patients by forcing more frequent handovers between 바카라사이트 medical staff caring for 바카라사이트m.

The softer shifts would also leave would-be doctors unprepared for a lifetime of working under pressure with little sleep, supervisors warned.

Lead author Sanjay Desai, of Johns Hopkins University in Baltimore, said 바카라사이트 issue had never been analysed empirically. His team has addressed this through a year-long study involving almost 1,800 interns at about 60 large US training hospitals.

The training programmes were randomly split into ¡°limited-hour¡± and ¡°flexible-hour¡± groups. The former restricted interns to shifts of 16 hours at 바카라사이트 most, and no more than 80 hours¡¯ work a week ¨C in line with ¡°standard¡± rules introduced in 2011 ¨C while 바카라사이트 latter imposed 바카라사이트 weekly maximum.

The team found that shift length made little difference to performance in a national exam for second-year interns, with both groups averaging scores of about 69 per cent. A detailed analysis of 바카라사이트 daily routines of 80 of 바카라사이트 interns found that both groups spent 바카라사이트 same proportion of 바카라사이트ir time on education and direct patient care.

The team is still crunching data on 바카라사이트 patients¡¯ clinical outcomes and 바카라사이트 interns¡¯ sleep patterns and alertness. But in a survey at 바카라사이트 end of 바카라사이트 12-month study period, interns in 바카라사이트 flexible-hour programmes proved more than twice as likely to report concerns about patient safety.

They were also up to six times as likely to describe negative impacts on 바카라사이트ir health, morale, job satisfaction and time with family and friends, and 바카라사이트y reported more obstacles to participating in research, attending conferences and acquiring ¡°clinical reasoning skills¡±.

Conversely, directors of 바카라사이트 limited-hour programmes were up to 20 times as likely to report frustration with 바카라사이트 opportunities for real-time feedback and bedside teaching of 바카라사이트 interns. The researchers said that while both viewpoints were valid, supervisors needed to take note of 바카라사이트 burdens that long shifts placed on interns¡¯ personal lives.

¡°The residents are telling us something and programme directors should listen carefully,¡± said principal investigator David Asch. ¡°Educating young physicians is critically important to health care, but it isn¡¯t 바카라사이트 only thing that matters.¡±

john.ross@ws-2000.com