A 3-Year Study of Resident Reaction to 2011 ACGME Work Hour Rules in a Family Medicine Residency.

INTRODUCTION: 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour rules prompted concerns regarding potential negative impacts on patient care and resident education. We were interested in resident reaction to call restructuring and night oat (NF) in a family medicine residency over 3 years following implementation of the 2011 rules. METHODS: We conducted structured interviews of residents from 2011-2012 through 2013-2014. Interviews were recorded, transcribed, and analyzed for themes. RESULTS: Fifty-eight interviews were conducted, including 18/18 residents in 2011-2012 (100%), 18/20 residents in 2012-2013 (90%), and 22/22 residents in 2013-2014 (100%). Following introduction of the 24-hour work limit, upper year residents reported significantly less fatigue and improved personal lives, patient care, and educational experience. Reactions to NF varied with length and intensity of the NF rotation; most PGY-1 residents reported increased fatigue, more burnout, and worse personal lives on NF. Most residents felt patient care quality on NF did not differ from non-NF rotations because improved inpatient nighttime continuity mitigated effects of fatigue and increased care transitions. Reactions regarding educational experience on NF were initially negative, but improved over time. CONCLUSIONS: Residents' reactions to 2011 ACGME work hour rules suggest the rules improved resident well-being, except on NF. Negative effects of NF may be minimized by limiting NF rotations to 5 nights/week for 2 consecutive weeks, and 1 month total per academic year.

Resident knowledge acquisition during a block conference series.

OBJECTIVE: This study's objective was to determine whether attendance at lectures in a block conference format improves residents' knowledge. METHODS: Seventeen family medicine residents were tested on the content of 27 lectures delivered in a block conference format over a 6-month period. For each lecture, residents completed a pretest, a short-term posttest, and a long-term posttest (1--3 weeks and 1.5--6 months after each lecture, respectively). RESULTS: Mean short-term posttest scores were 10.3 points higher for lecture attendees than nonattendees. Mean long-term posttest scores did not differ significantly for attendees (62.2) versus nonattendees (60.0). CONCLUSIONS: Attendance at didactic lectures in a block conference format did not improve resident knowledge over the long term. These results lead us to question the value of a block conference format and raise the possibility that resident learning might be better served by maximizing clinical experiences and minimizing time in conferences.

Resident acquisition of knowledge during a noontime conference series.

BACKGROUND AND OBJECTIVES: Noontime conferences are widely used in family practice residencies. This study determined the effectiveness of noontime conferences for increasing residents' knowledge. METHODS: Twenty residents were tested monthly over 6 months and then cumulatively on the content of noontime conferences. RESULTS: Monthly test scores of attendees versus nonattendees were compared using a two-sample, two-tail t test. Results revealed the mean score of attendees for short-term knowledge to be 12.1 points higher than nonattendees. There was no correlation, however, between conference attendance and long-term knowledge retention. CONCLUSIONS: Our findings indicate a lack of correlation between noontime conference attendance and long-term cumulative test scores. The results question the value of noontime conferences as a teaching method.