Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Educations 30-hour duty period requirement

Christopher G. Maloney, Armand H.Matheny Antommaria, James F. Bale, Jian Ying, Tom Greene, Rajendu Srivastava

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: In 2003 the Accreditation Council for Graduate Medical Education mandated work hour restrictions. Violations can results in a residency program being cited or placed on probation. Recurrent violations could results in loss of accreditation. We wanted to determine specific intern and workload factors associated with violation of a specific mandate, the 30-hour duty period requirement. Methods. Retrospective review of interns performance against the 30-hour duty period requirement during inpatient ward rotations at a pediatric residency program between June 24, 2008 and June 23, 2009. The analytical plan included both univariate and multivariable logistic regression analyses. Results: Twenty of the 26 (77%) interns had 80 self-reported episodes of continuous work hours greater than 30hours. In multivariable analysis, noncompliance was inversely associated with the number of prior inpatient rotations (odds ratio: 0.49, 95% confidence interval (0.38, 0.64) per rotation) but directly associated with the total number of patients (odds ratio: 1.30 (1.10, 1.53) per additional patient). The number of admissions on-call, number of admissions after midnight and number of discharges post-call were not significantly associated with noncompliance. The level of noncompliance also varied significantly between interns after accounting for intern experience and workload factors. Subject to limitations in statistical power, we were unable to identify specific intern characteristics, such as demographic variables or examination scores, which account for the variation in noncompliance between interns. Conclusions: Both intern and workload factors were associated with pediatric intern noncompliance with the 30-hour duty period requirement during inpatient ward rotations. Residency programs must develop information systems to understand the individual and experience factors associated with noncompliance and implement appropriate interventions to ensure compliance with the duty hour regulations.

Original languageEnglish (US)
Article number33
JournalBMC Medical Education
Volume12
Issue number1
DOIs
StatePublished - May 24 2012

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Graduate Medical Education
Accreditation
accreditation
Internship and Residency
Workload
graduate
workload
Inpatients
education
Odds Ratio
Pediatrics
probation
Information Systems
information system
experience
Logistic Models
confidence
logistics
Regression Analysis
Demography

ASJC Scopus subject areas

  • Education

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Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Educations 30-hour duty period requirement. / Maloney, Christopher G.; Antommaria, Armand H.Matheny; Bale, James F.; Ying, Jian; Greene, Tom; Srivastava, Rajendu.

In: BMC Medical Education, Vol. 12, No. 1, 33, 24.05.2012.

Research output: Contribution to journalReview article

Maloney, Christopher G. ; Antommaria, Armand H.Matheny ; Bale, James F. ; Ying, Jian ; Greene, Tom ; Srivastava, Rajendu. / Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Educations 30-hour duty period requirement. In: BMC Medical Education. 2012 ; Vol. 12, No. 1.
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