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Understanding residents' work: moving beyond counting hours to assessing educational value.
1Office of Health Services Organization and Research, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio 44272, USA. jrb@neoucom.edu
Academic Medicine : Journal of the Association of American Medical Colleges
|September 26, 2003
Summary
Resident physicians spend significant time on patient care with educational value, but also considerable time on marginal or unspecified activities. Evaluating the educational content of resident work is crucial for reforms.
Area of Science:
- Medical Education Research
- Physician Training
- Workforce Analysis
Background:
- Understanding resident physician activities is key to assessing training quality.
- Previous analyses have not fully quantified the educational value of resident work.
Purpose of the Study:
- To systematically review and analyze resident physicians' activities.
- To assess the educational value derived from residents' work during training.
Main Methods:
- Systematic literature review of published and unpublished studies up to 2001.
- Inclusion of 16 studies (over 1,000 residents) meeting methodological rigor criteria post-1987.
- Categorization of resident activities into patient care, teaching/learning, marginal, and other.
Main Results:
- Residents dedicated approximately 36% of effort to educationally valuable patient care.
- 15% of time was spent on organized teaching activities.
- Up to 35% of time may have been spent on marginal educational value patient care, with 16% in unspecified activities.
Conclusions:
- Residency work hour reforms should consider educational content, not just hours worked.
- Quantifying the educational value of resident activities is essential for optimizing training programs.