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Tuesday, October 27, 2015

Resident Trainees Spend Just 12% of Their Time With Patients

Interns and residents spend more time communicating with their peers and working at the computer than dealing face-to-face with patients. A multicenter time-motion study found that whereas trainees spent 34.7% of work time in interprofessional communication and 20.5% at the keyboard, they spent just 12.0% dealing directly with patients and their families, and 4.7% in educational activities.

Reporting in a research letter published online October 26 in JAMA Pediatrics, Amy L. Starmer, MD, MPH, from the Division of General Pediatrics at Boston Children's Hospital in Massachusetts, and colleagues analyzed 3452 hours of time-motion data on work flow patterns from the pediatric wards of nine hospitals.

They found that residents spent more time than interns in interprofessional communication (38.3% vs 31.1%; P = .001), and less time in contact with patients and families (10.3% vs 13.7%; P < .001).

Unsurprisingly, trainees on night shifts spent less time in interprofessional communication (29.5% vs 39.3%; P < .001) and education (1.5% vs 7.6%; P < .001) than trainees did during day shifts, and in addition, they spent more time in contact with patients and families (13.8% vs 10.2%; P < .001).

Similarly, on weekends, trainees devoted less time to educational activities (1.4% vs 6.2%; P < .001) and interprofessional communication (29.9% vs 36.7%; P = .007) than they did on weekdays.

"As resident-physician work hours have decreased, and patient complexity and hospital documentation have concurrently increased, concerns have mounted about the time residents have available for education and face-to-face patient care," Dr Starmer and colleagues write. They point to a previous study in which 40% of trainee time was spent at the computer vs 12% with patients.

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