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首页> 外文期刊>The Journal of Bone and Joint Surgery. American Volume >The impact of the accreditation council for graduate medical education work-hour regulations on the surgical experience of orthopaedic surgery residents.
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The impact of the accreditation council for graduate medical education work-hour regulations on the surgical experience of orthopaedic surgery residents.

机译：研究生医学教育工作时间规例认证委员会对整形外科住院医师手术经验的影响。

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BACKGROUND: The advent of the eighty-hour workweek regulations generated a great deal of controversy over the potential loss of operative experience for general surgery and surgical specialty residents. We believed an investigation to review the operative experience of orthopaedic surgery residents before and after the adoption of the Accreditation Council for Graduate Medical Education duty-hour guidelines would provide important information in this debate. METHODS: The total number of surgical Current Procedural Terminology codes logged in the case-log database of the Accreditation Council for Graduate Medical Education by each second through fifth year orthopaedic resident at a single university-based program was collected from July 1, 2001, to June 30, 2005. Two groups were created from the data obtained. Group I (thirty-nine residents) included surgical codes logged for the two years prior to the implementation of the eighty-hour workweek (July 1, 2003), while Group II (forty residents) included the codes for the following two years. The average number of codes was determined for Group I and Group II. The two groups were then subdivided by postgraduate year of training. The average number of surgical codes per training year was calculated. Then the second and third year (junior) resident and fourth and fifth year (senior) resident groups were combined to create two subgroups. The mean number of surgical codes was determined for each group, and the groups were compared. RESULTS: The surgical case logs of thirty-five orthopaedic residents were reviewed during the study period. One resident left the program during the first year of the study and was excluded because of incomplete data. A total of 36,464 surgical codes were logged. The average yearly number of surgical codes per resident was 461.4. The average total number of coded procedures per resident before and after the start of the eighty-hour workweek were 455.4 and 467.3, respectively. The average yearly number of surgical codes was 432.5 for the junior residents and 491.1 for the senior residents. The average number of codes logged before and after the start of the eighty-hour workweek were 407.3 and 455.3, respectively, for the junior residents compared with 501.2 and 480.6 for the senior residents. No significant differences between the groups in any category were identified. CONCLUSION: Although many aspects of surgical training may be affected by the new work-hour restrictions, our review of the operative experience of orthopaedic surgery residents at a single institution demonstrated no significant differences before and after the implementation of the eighty-hour workweek.
机译：背景：每周工作八十小时的规定的出台，引起了对一般外科手术和外科专科住院医师潜在的手术经验损失的争议。我们认为，通过一项研究以审查整形外科住院医师的手术经验，该研究在通过研究生医学教育认可委员会工作时间指南之前和之后均会提供重要信息。方法：从2001年7月1日至2004年，收集每位第二至第五年的骨科住院医师在一个大学项目中，记录在研究生医学教育认可委员会的案例日志数据库中的外科现行程序术语代码总数。 2005年6月30日。根据获得的数据创建了两个小组。第一组（三十九名居民）包括实施八十小时工作周（2003年7月1日）之前两年的手术规范，而第二组（四十名居民）包括了随后两年的手术规范。确定第一组和第二组的平均代码数。然后将两组按研究生的培训年级细分。计算每个训练年的平均手术次数。然后将第二和第三年（初中）居民组以及第四和第五年（高级）居民组合并为两个子组。确定每组的平均手术规程数，并比较各组。结果：在研究期间对35名骨科住院医师的手术病例记录进行了回顾。在研究的第一年，一名居民离开了该计划，由于数据不完整而被排除在外。总共记录了36,464项手术代码。每位居民平均每年的手术法规为461.4。在八十小时工作周开始之前和之后，每位居民的平均编码程序总数分别为455.4和467.3。初级居民的年平均手术编码为432.5，老年人为491.1。初级居民在八十小时工作周开始之前和之后记录的平均代码分别为407.3和455.3，而老年人为501.2和480.6。没有发现任何类别的组之间的显着差异。结论：尽管新的工作时间限制可能会影响外科手术训练的许多方面，但我们对单一机构骨科手术住院患者的手术经验的回顾显示，实施每周80小时的工作前后没有显着差异。

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