E. Oddone et al., COMPARISON OF HOUSESTAFFS ESTIMATES OF THEIR WORKDAY ACTIVITIES WITH RESULTS OF A RANDOM WORK-SAMPLING STUDY, Academic medicine, 68(11), 1993, pp. 859-861
Citations number
7
Categorie Soggetti
Medicine Miscellaneus","Education, Scientific Disciplines
Background. Accurately quantifying housestaff's workday activities is
acquiring increasing importance as resources become constrained and pr
ograms become more accountable for medical education. The authors comp
ared a traditional method of time analysis based on housestaff's estim
ates of how they spent their workdays with the results of a formal tim
e-analysis study based on random work sampling. Method. All housestaff
(18 interns and 18 residents) rotating on a general medicine service
at Duke University Medical Center between December 1991 and March 1992
participated in the study. Twenty-six of the housestaff first provide
d estimates of how they spent their workdays, and then all 36 wore ran
dom reminder beepers and recorded what they were doing (activity) and
with whom (contact) at each beep. Results. The housestaff overestimate
d the amounts of time spent in patient evaluation (e.g., the mean esti
mated proportion of time spent performing histories and physical exami
nations was 29%, whereas the mean actual proportion was 17%) and in ed
ucational activities (e.g., the mean estimated proportion of reading t
ime was 8.4%, whereas the mean actual proportion was 2.7%). The houses
taff underestimated the amount of supervision by attending physicians:
the mean estimated proportion was 7.7%, whereas the mean actual propo
rtion was 16.9%. Conclusion. The Housestaff's estimates of workday tim
es differed from the observed times measured by random work sampling.
These inaccuracies were manifest in several important areas, such as p
atient evaluation, educational activities, and attending physicians' s
upervision. These results suggest that program directors who seek to d
escribe housestaff's work activities or wish to determine the effects
of administrative interventions should use random work sampling as the
measure.