| Perspective: Ten Thousand Hours to Patient Safety, Sooner or Later. | |
| | |
MedLine Citation:
|
PMID: 22189877 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
A call by the Institute of Medicine to advance the cause of patient safety catalyzed the current focus on duty hours limits during resident education. Unrelated benefits to resident education have accrued from those efforts, but, despite rigorous study of the issue, there is little evidence of a positive impact on patient safety resulting from trainee duty hours adjustments. Moreover, the discussion has become worrisomely myopic in its singular preoccupation with the impact of postgraduate medical education duty hours on safe patient care.The author argues that patient safety efforts should focus instead on the three essential elements of capacity, of which a discussion of duty hours and fatigue are an important part, commitment, and competence. Commitment requires altruism and professionalism, which are discouraged by a shift-work orientation. Competence is essential for safe patient care; as duty hours are constricted in the name of reducing fatigue-related medical error, it must be remembered that a certain amount of time is required to both acquire a knowledge base and attain proficiency in needed technical skills. Until a competency-based educational system can be implemented, the profession and patients would be well served by a heightened awareness of the increased number of years required in a constrained work hours environment to achieve proficiency in the independent practice of medicine, especially when procedural competence is required. Such a realization will inevitably result in voluntary lengthening of some residency training programs, particularly in surgical disciplines and those medical specialties with a prominent procedural component. |
| | |
Authors:
|
Vincent D Pellegrini |
Related Documents
:
|
10219387 - Suppression of post-caloric nystagmus in experimental perilymph fistula. 21909977 - Performing clinical studies involving hernia mesh devices: what every investigator shou... 18387707 - Medical response to a radiologic/nuclear event: integrated plan from the office of the ... 22238047 - Role of simulation in us physician licensure and certification. 22458747 - Patient factors, but not provider and health care system factors, predict medication ad... 22225447 - Influence of study approaches on academic outcomes during pre-clinical medical education. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-12-20 |
Journal Detail:
|
Title: Academic medicine : journal of the Association of American Medical Colleges Volume: - ISSN: 1938-808X ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
|
Created Date: 2011-12-22 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8904605 Medline TA: Acad Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Dr. Pellegrini is James L. Kernan Professor and Chair, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Perspective: A Proposed Medical School Curriculum to Help Students Recognize and Resolve Ethical Iss...
Next Document: Perspective: The Potential of Student Organizations for Developing Leadership: One School's Experien...