At the Crack of Dawn: Resident Working Hours and Improving Antibiotic Prescribing

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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.

Follow us on Twitter @roundstable, and let us know how you liked this week’s #ClinicalEncounter segment on men who have sex with men (MSM)!

The Papers

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

Good Stuff

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

3. PRAISE study: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61205-2/abstract

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.

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