RESIDENT EDUCATIONAL TIME STUDY - A TALE OF 3 SPECIALTIES

Objective: To compare amounts of in-hospital time use by PGY1 resident s during rotations in emergency medicine (EM), internal medicine (IM), and surgery. This article reports the general study methodology and f ocuses on the educational aspects of residency time use. Methods: A cr oss-sectional, observational study of the activities of Ehl PGY1 resid ents was performed while the residents were on duty during the 3 speci alty rotations. The activities were recorded by an observer using a lo g with predetermined categories for clinical/service, educational, and personal areas. A time-blocked, convenience sample of resident shifts was observed for each service rotation. The sample was proportional D o the total number of hours for which a PGY1 resident was expected to be in the hospital during a rotation on that service. No attempt was m ade to sample the same resident at all time periods or on all rotation s. Results: Twelve PGY1 residents were observed for a total of 166 hou rs on surgery, 156 hours on IM, and 120 hours on EM. These hourly amou nts were representative of a typical 2-week span of service on each ro tation for the residents. On average, the residents spent 57% of their time on clinical or service-oriented activities, 24% on educational a ctivities, and 19% on personal activities. The proportions of time dev oted to the 3 major areas were similar for the 3 rotations. In all 3 r otations, the largest proportion of time was spent on patient-focused education (81% to 92% of total educational time). Only 2% to 11% of ed ucational time was devoted to self-education. Within the patient-focus ed education category, proportionately less resident time with faculty occurred on the surgery rotation than on the EM and IM rotations (18% vs 30% and 27%, respectively). Conclusion: The general breakdowns of clinical/service, educational, and personal time use by PGY1 residents are proportionately similar for the 3 service rotations. Patient-focu sed education is the primary mode of education for all services. In-ho spital, self-education time is limited. Clinical teaching is largely b y nonfaculty. The educational implications of these findings are discu ssed.