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West J Emerg Med. 2018 Jan;19(1):49-58. doi: 10.5811/westjem.2017.11.35265. Epub 2017 Dec 22.

ACGME Clinical and Educational Work Hour Standards: Perspectives and Recommendations from Emergency Medicine Educators.

Author information

1
University of Virginia School of Medicine, Department of Emergency Medicine, Charlottesville, Virginia.
2
Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.
3
Council of Emergency Medicine Residency Directors, Irving, Texas.
4
University of California Davis School of Medicine, Department of Emergency Medicine, Sacramento, California.
5
American College of Emergency Physicians, Irving, Texas.
6
Maricopa Medical Center, Department of Emergency Medicine, Phoenix, Arizona.
7
University of Arizona College of Medicine- Phoenix, Maricopa Medical Center, Department of Emergency Medicine, Phoenix, Arizona.
8
Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado.
9
University of Queensland/Ochsner Health System, Department of Emergency Medicine, New Orleans, Louisiana.
10
University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa.

Abstract

Introduction:

The American College of Emergency Physicians (ACEP) and the Council of Emergency Medicine Residency Directors (CORD) were invited to contribute to the 2016 Accreditation Council for Graduate Medical Education's (ACGME) Second Resident Duty Hours in the Learning and Working Environment Congress. We describe the joint process used by ACEP and CORD to capture the opinions of emergency medicine (EM) educators on the ACGME clinical and educational work hour standards, formulate recommendations, and inform subsequent congressional testimony.

Methods:

In 2016 our joint working group of experts in EM medical education conducted a consensus-based, mixed-methods process using survey data from medical education stakeholders in EM and expert iterative discussions to create organizational position statements and recommendations for revisions of work hour standards. A 19-item survey was administered to a convenience sample of 199 EM residency training programs using a national EM educational listserv.

Results:

A total of 157 educational leaders responded to the survey; 92 of 157 could be linked to specific programs, yielding a targeted response rate of 46.2% (92/199) of programs. Respondents commented on the impact of clinical and educational work-hour standards on patient safety, programmatic and personnel costs, resident caseload, and educational experience. Using survey results, comments, and iterative discussions, organizational recommendations were crafted and submitted to the ACGME.

Conclusion:

EM educators believe that ACGME clinical and educational work hour standards negatively impact the learning environment and are not optimal for promoting patient safety or the development of resident professional citizenship.

PMID:
29383056
PMCID:
PMC5785201
DOI:
10.5811/westjem.2017.11.35265
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

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