An evaluation of resident work profiles, attending-resident teaching interactions, and the effect of variations in XXXX volume on each.

@entity1 @entity341 @entity3970 @entity1262
OBJECTIVES: This study examines the effect of variations in @entity341 ( @entity341 ) volume on physician work efficiency (new @entity1 per hour) and work profile ( @entity1 -related activities, including both direct and indirect @entity1 care) and whether these differ between first- (Postgraduate Year [ @entity1262 ) and third- ( @entity3970 ) year residents. The authors also determine if changes in volume are associated with changes in teaching interactions between attending and resident physicians. METHODS: This was a prospective observational study of resident and attending physicians in the @entity341 . Research assistants (RAs) followed @entity341 residents during clinical shifts and recorded a multitude of data including the amount of time spent in specific activities, the number of new @entity1 seen, and the frequency of attending physician teaching interactions. RESULTS: Third-year residents see more new @entity1 per hour (1.79 vs. 1.16, p < 0.001) than do their first-year counterparts. In addition, third-year residents spend almost 50% less time with each @entity1 (10.7 minutes vs. 19.4 minutes, p < 0.001), and first-year residents spend three times as much time per shift discussing @entity1 with attending physicians (59.4 minutes vs. 27.3 minutes, p = 0.002). More of the @entity1262 /attending interactions resulted in educational exchanges (54.9% vs. 34.6%, p = 0.003). @entity1262 residents also spend more time on dictations per @entity1 (9.6 minutes vs. 5.4 minutes, p = 0.01) and more time on paperwork per @entity1 (18.5 minutes vs. 6.5 minutes, p = 0.007). As @entity341 volume tripled, @entity1262 residents were able to increase their @entity1 load to a greater extent than were @entity3970 residents by decreasing the length of each @entity1 encounter as volume increased. Overall, @entity341 volume had no effect on the number of teaching interactions, although the length of exchange decreased as volume increased. CONCLUSIONS: Third-year residents see and carry more @entity1 than do their first-year counterparts. They do so primarily by decreasing the amount of time spent with @entity1 and attendings and working more efficiently overall. However, they are not as capable of altering their work profiles in the face of increased volume as their first-year counterparts. While the length of teaching interactions is decreased as volume increases, the number of those interactions resulting in teaching remains constant regardless of volume.
