Duty hours reforms in the United States, France, and Canada: Is it time to refocus our attention on education?

被引:45
作者
Woodrow, Sarah I.
Segouin, Christophe
Armbruster, Judith
Hamstra, Stanley J.
Hodges, Brian
机构
[1] Univ Toronto, Wilson Ctr Res Educ, Fac Med, Toronto, ON M5G 2C4, Canada
[2] Univ Toronto, Dept Surg, Toronto, ON, Canada
[3] Univ Denis Diderot, Sch Med, Paris, France
[4] Univ Hosp Paris, APHP, Serv Continuing Med Educ, Paris, France
[5] Accreditat Council Grad Med Educ, Anesthesiol Diagnost Radiol & Nucl Med, Chicago, IL USA
[6] Univ Michigan, Dept Med Educ, Ann Arbor, MI 48109 USA
[7] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
关键词
D O I
10.1097/01.ACM.0000246751.27480.55
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Resident duty hours restrictions have now been instituted in many countries worldwide. Such policies have resulted in a broad-based discussion in the medical literature concerning their effects on patient care, resident education, and resident well-being. To better understand the impetuses behind these changes, the authors examine not only the duty hours mandates currently in effect in the United States, Canada, and France, but also the events influencing their independent development in these three countries. In the United States, an 80-hour resident workweek was mandated by the Accreditation Council for Graduate Medical Education out of concern for patient safety. In France, a 52.5-hour workweek was decreed by the government, reflecting the broader European Working Time Directive initiated out of concern for the negative impact of extended work hours on its population. In Canada, resident unions, whose primary interest has been one of resident well-being, have negotiated a series of reduced resident duty hours that approach those mandated in the United States. At the core of these changes are unique differences in these countries' health care and medical education systems. The resulting diversity in the origin and nature of such regulations serves to highlight the lack of evidence that has guided their development and the need to refocus on the educational elements of postgraduate training.
引用
收藏
页码:1045 / 1051
页数:7
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