Fatigue Management

The ACGME requires that every program educate their faculty and trainees on fatigue.

Fatigue management training is available through HealthStream.

Additional training is offered below.

Effect of Fatigue on Trainee Learning and Performance

The video of the March 5, 2012 presentation by Dr. Lawrence J. Epstein on "Sleep and Fatigue: Impact on Trainee's Learning and Performance" is available to Mass General Brigham residents, fellows, faculty, and staff.

Learning to Address Impairment and Fatigue

Learning to Address Impairment and Fatigue to Enhance Patient Safety - Volume 1 (best with Internet Explorer. It might not open in other browsers.)
Learning to Address Impairment and Fatigue to Enhance Patient Safety - Volume 2  (best with Internet Explorer. It might not open in other browsers.)

Each 25-minute learning module includes engaging video clips and text, as well as a bibliography to support the recommendations.

The LIFE Curriculum is a collaborative effort of Duke University Hospital, the UNC Hospitals, the NC AHEC, and the NC Physician's Health Program to assist graduate medical education programs, their residents, and faculty to prevent, identify, and manage resident fatigue and impairment. The project is funded in part by a grant from the Josiah Macy, Jr. Foundation.

The self-assessment portion of the video is not available and CME Credits are no longer available. Residents and Fellows can self claim AMA category 2 credit.

Please note that the links to the “additional resources” in the video do not work. The “additional resources” are located below.

Thank you for working together with us to meet this important requirement.

Introduction

1. Life Curriculum Advisory Board
2. Life Curriculum  Faculty
3. Residents' Focus Group

Fatigue

1. Work-Hour Restrictions: Do They Impact the Learning Experience
2. Learning Objectives 
3. Sleep Cycle  
4. Fatigue and Impairment 
5. Fatigue and Resident Health
6. Fatigue and Resident Well-Being
7. Night Floats, Fatigue, Handoffs
8. ACGME Standards
9. Accreditation Council for Graduate Medical Education (ACGME)
10. ACGME clarifies misperceptions on Duty Hour Standards
11. Milestone in the History of the Problem
12. Additional References of Interest
13. David Dinges, PhD, Bibliography
14. Web Resources
    

Stress and Depression

1. Learning Objectives
2. Situational Stressors
3. Personal Stressors
4. Alleviating Stress in a Relationship: Recommendations
5. Professional Stressors
6. Physical, Emotional, Behavioral Signs and Symptoms of Stress
7. Stress Management in Residency Programs
8. Stress Management Techniques
9. DSM-IV Criteria for Major Depressive Episode
10. Additional References of Interest
11. Web Resources

Substance Abuse

1. Learning Objectives
2. DSM-IV Criteria for Substance Abuse and Substance Dependence
3. Signs and Symptoms Indicative of Substance Abuse
4. Principles of Intervention
5. Common Issues Involving Residents Suspected of Substance Abuse
6. Reporting to the National Practitioner Data Bank: (NPDB)
7. Steps Programs Can Take to Help Combat Substance Abuse
8. Additional References of Interest 

Disruptive Behavior

1. Learning Objectives
2. Signs and Symptoms of Disruptive Behavior in Physicians
3. Medical Staff Code of Conduct Policy and Procedures to Deal with Violations: Example 
4. North Carolina Medical Board Statement on Harassment: Example

Burnout

1. Learning Objectives
2. Working Harder: The Vicious Cycle of Burnout
3. Signs and Symptoms of Burnout
4. Harassment Policy- State Medical Board
5. Resources for Money Management and Loan Repayment 
6. Steps to Address a Resident’s Sense of Mistreatment
7. Steps to Reduce Stress by Taking Care of Yourself
8. Alternate Careers Related to Medicine
9. Additional References of Interest 

Boundary Violations

1. Learning Objectives
2. Transference and Countertransference
3. Policy Regarding Gifts
4. Cultural Aspects of Care 
5. Sex and Power
6. Sexual Violation versus Sexual Impropriety
7. Proposed Causes of Boundary Violations in Physicians
8. Consequences to Patients of Boundary Violations
9. The Slippery Slope
10. Examples of a Professional Expectations Form for Residents
11. Additional References of Interest 

Impairments

1. Learning Objectives
2. Notification of Corrective Action (Examples)
3. Plan of Remediation During Corrective Action
4. Letter: Feedback During Corrective Action Process
5. Letter: Expectations and Recommendations to Pursue Disability Consult
6. Non-renewal of Contract 
7. Learning Disabilities and the ADA
8. Cases that have shaped Disability Services 
9. Examples of Included/Excluded Conditions Decided by the ADA and Subsequent Court Cases
10. Acceptable and Unacceptable Questions for Applicants or Established Residents
11. Example of an Essential Job Function List
12. Additional References of Interest

Instructive Feedback

1. Learning Objectives
2. Top Ten Reasons We Avoid Talking with Someone About a Problem
3. Six Traps in the Evaluation Process
4. The Five-Stage Process for Giving and Receiving Critical Feedback
5. Additional References of Interest

Conclusion

Corrective Action and Hearing Procedures: The 5 Step Protocol

The LIFE Curriculum (duke.edu)

This page was reviewed on 10/24/21.