Sampling clinicians' activities using electronic pagers

Pager-based activity sampling (PAS) is described as a cost-effective and unobtrusive method for sampling residents' activities in clinical settings. A sample program evaluation is presented using residents in an urban children's hospital resident-training program. The purposes of the program evaluation were: (a) to establish a behavioral baseline that would help clinical faculty understand how residents were using their time, and (b) to determine whether alterations in the way residents were assigned within the hospital resulted in desired changes to time spent. The primary rationale for changing resident-assignment policies were: (a) to decrease the time residents were spending in transit between various locations within the hospital, and (b) to increase the time spent by residents in educational activities and in direct contact with patients and their families. This PAS application demonstrates that the technique can produce statistically supportable conclusions, at minimal cost, without unduly disrupting either the residents or their patients. PAS is compared with other time-sampling methods, its limitations are discussed, and suggestions for future applications are provided.