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What do surgery residents do on their call nights?
John M Morton1, Christopher C Baker, Timothy M Farrell
1Department of Surgery, University of North Carolina, Chapel Hill, NC, USA. morton@stanford.edu
American Journal of Surgery
|September 29, 2004
Summary
Surgical residents spend most on-call time on daily tasks and patient evaluation, with sleep comprising nearly a third. Direct patient contact is minimal, highlighting areas for improving resident education and patient care.
Area of Science:
- Medical Education
- Surgical Training
- Healthcare Operations
Background:
- Surgical resident education faces challenges in competency achievement due to work hour limitations.
- Assessing on-call activities is crucial for optimizing educational value and resident experience.
Purpose of the Study:
- To analyze the time allocation and activities of surgical residents during on-call shifts.
- To identify key components of on-call duties and their impact on resident education and patient care.
Main Methods:
- A time-motion study was conducted at a university medical center and an urban affiliate hospital.
- "Shadow" residents meticulously recorded the activities of on-call residents.
Main Results:
- Activities of daily living and patient evaluation constituted the majority of on-call duties.
- Residents slept a median of 200 minutes per night, nearly one-third of the call period.
- Direct patient contact represented only 7% of call night duties, while communication accounted for 15%.
Conclusions:
- On-call activity is dominated by non-direct patient care tasks, including daily activities, patient evaluation, and communication.
- The significant amount of sleep time suggests potential for restructuring call schedules.
- Findings can inform improvements in surgical resident education, call experience, and patient care delivery.