At the Crack of Dawn: Resident Working Hours and Improving Antibiotic Prescribing
This week, Amol, general internal medicine resident at the University of Toronto, and Nathan, general surgery resident also at the University of Toronto, discuss two recent papers:
Resident duty hours have been a hotly debated topic for some time. A randomized control trial of United States residency programs compared conventional American duty hour regulations that are more stringent to a more flexible policy. The study found that between the two groups, there was no difference in patient outcomes, nor a difference in resident perceived training satisfaction and wellbeing. Amol and Nathan discuss how these results could be interpreted.
What is the most effective way to change physician behavior? A randomized control trial of primary care practices found that behavioral interventions could reduce inappropriate antibiotic prescribing for patients with upper respiratory infections. Amol and Nathan discuss how accountable justification and peer comparison appeal to the psychology of care providers.
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1. Surgery duty hours: http://www.nejm.org/doi/full/10.1056/NEJMoa1515724
2. Improving antibiotic prescribing: http://jama.jamanetwork.com/article.aspx?articleid=2488307
1. Sobriety program: http://www.vox.com/2016/2/9/10955138/alcohol-247-sobriety-program
2. Domestic violence screening: http://healthydebate.ca/2016/02/topic/domestic-violence-healthworkers-screening-hospitals
Music Credits (Creative Commons)
In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart
Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music
Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music
All tracks have been modified for the purposes of this podcast.