resident physician
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Introduction
A physician in training, after completion of medical school.
An intern is a first year resident.
Interns & residents staff many hospitals.
Complications
- resident & intern service changes are associated with increased mortality among hospitalized patients[1]
Notes
- dissatisfaction with flexible hours[2]
- little time spent in direct patient care for all trainees (suggesting extended amounts of time engaging with EMRs)[2]
- greater inpatient attending supervision may lead to decreased autonomy in resident decision-making without improving patient safety[3]
- flexible vs standard hours resulted in similar patient-safety & trainee-restfulness outcomes[4]
More general terms
References
- ↑ 1.0 1.1 Denson JL, Jensen A, Saag HS et al Association Between End-of-Rotation Resident Transition in Care and Mortality Among Hospitalized Patients. JAMA. 2016;316(21):2204-2213 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27923090 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2589342
Arora VM, Farnan JM Inpatient Service Change: Safety or Selection? JAMA. 2016;316(21):2193-2194 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27923077 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2589329 - ↑ 2.0 2.1 2.2 Desai SV, Asch DA, Bellini LM et al. Education outcomes in a duty-hour flexibility trial in internal medicine. N Engl J Med 2018 Mar 20; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29557719 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1800965
McMahon GT. Managing the most precious resource in medicine. N Engl J Med 2018 Mar 20; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29557706 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMe1802899 - ↑ 3.0 3.1 Finn KM, Metlay JP, Chang Y, et al. Effect of increased inpatient attending physician supervision on medical errors, patient safety, and resident education: a randomized clinical trial. JAMA Intern Med. 2018 Jun 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29868877 https://psnet.ahrq.gov/resources/resource/32197
- ↑ 4.0 4.1 Basner M, Asch DA, Shea JA et al. Sleep and alertness in a duty-hour flexibility trial in internal medicine. N Engl J Med 2019 Mar 7; 380:915-923. PMID: https://www.ncbi.nlm.nih.gov/pubmed/3085574 https://www.nejm.org/doi/10.1056/NEJMoa1810641
Silber JN, Bellini LM, Shea JA et al. Patient safety outcomes under flexible and standard resident duty-hour rules. N Engl J Med 2019 Mar 7; 380:905-914. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30855740 https://www.nejm.org/doi/10.1056/NEJMoa1810642
Rosenbaum L, Lamas D. Eyes wide open - Examining the data on duty-hour reform. N Engl J Med 2019 Mar 7; 380:969-970. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30855748 https://www.nejm.org/doi/10.1056/NEJMe1817497