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First-postgraduate-year resident clinical time use on three specialty rotations
A R Magnusson1, J R Hedges, R J Harper
1Department of Emergency Medicine, Oregon Health Sciences University, Portland 97201, USA.
Summary
First-year residents spend most clinical time on patient care, with variations between Emergency Medicine, Internal Medicine, and Surgery rotations. Documentation time is high in EM and IM, while procedural opportunities are greatest in Surgery.
Area of Science:
- Medical Education
- Residency Training
- Clinical Practice Analysis
Background:
- Understanding how residents allocate their time is crucial for optimizing educational experiences.
- First-year postgraduate year 1 (PGY1) residents rotate through various specialties, each with unique demands.
Purpose of the Study:
- To compare in-hospital time utilization by PGY1 residents across Emergency Medicine (EM), Internal Medicine (IM), and Surgery (S) rotations.
- To detail the clinical components of residency time use.
Main Methods:
- A cross-sectional, observational study design was employed.
- PGY1 residents' clinical activities were logged by observers during EM, IM, and S rotations.
- Time-blocked convenience sampling of resident shifts was used, proportional to expected hospital hours.
Main Results:
- Residents spent an average of 57% of their time on clinical or service-oriented activities.
- EM and IM residents focused 52% of clinical time on information gathering, case management, and data synthesis.
- Surgery rotations offered the most procedural opportunities (31% of clinical time), significantly more than EM/IM (6%).
Conclusions:
- Residency directors can use time-use data to identify educational needs and balance resident experiences.
- Enhancing documentation skills and efficiency is recommended for PGY1 EM and IM rotations, where charting consumes 29% and 42% of clinical time, respectively.
- Increasing procedural experience for PGY1 residents outside of Surgery rotations is warranted.