Roger A. Rivera Jr., MD, David J. Cennimo, MD, Christin M. Traba, MD, MPH, Susan G. Mautone, MD, Pediatrics, UMDNJ - New Jersey Medical School, Newark, NJ
Background: Recent attention has focused on change in resident duty hours as it pertains to resident education and patient safety, but there are no published data on the impact of these changes on medical student performance and mixed data on the impact on student perception and experience during third-year clerkships. In July 2004, 24-hour call was completely eliminated from the UMDNJ-New Jersey Medical School pediatric residency program. We analyze the effects of this change in resident duty hours on medical students’ performance and perceptions in the pediatric clerkship. Objectives: This study aims to determine if changes in resident duty hours affected our students’ perceptions of the quality of their clerkship experience and/or their educational outcomes as evidenced by clinical, OSCE and shelf exam grades. Methods: Medical students are surveyed at the end of each clerkship using a 1-5 Likert scale with 3=average, 4=well above average, 5=exceptional. Students evaluate the quality of their clinical experiences, attending and resident teaching, and the overall quality of the clerkship. Evaluation component means were calculated for each academic year. Student clinical performance is assessed by supervising faculty and residents throughout the clerkship. Mean clinical, OSCE and shelf exam grades for each academic year were also recorded. Data were analyzed for approximately 130 students per year. The aggregate data from four years before and four years after implementation of the change in resident duty hours were analyzed using ANOVA to determine any differences in grades or evaluations. Results: There were no significant differences in the students’ evaluations of the overall quality of their pediatric clerkship (p=0.9), nor of the quality of the inpatient (p=.87) or nursery (p=.25) components of the rotation before and after the change in resident duty hours. Student evaluation of resident and attending teaching also evidenced no significant differences pre- and post-change (p=.06 and .18 respectively). Students’ clinical performance, OSCE and shelf exam grades were not significantly different before and after the change in resident duty hours (p= .055, .67 and .05 respectively). Discussion: Program-wide reduction in resident duty hours did not adversely affect medical student performance or perceptions in this pediatric clerkship.