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The composition of intern work while on call. J Gen Intern Med 2012 Nov;27(11):1432-7



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2-s2.0-84867871221   39 Citations


BACKGROUND: The work of house staff is being increasingly scrutinized as duty hours continue to be restricted.

OBJECTIVE: To describe the distribution of work performed by internal medicine interns while on call.

DESIGN: Prospective time motion study on general internal medicine wards at a VA hospital affiliated with a tertiary care medical center and internal medicine residency program.

PARTICIPANTS: Internal medicine interns.

MAIN MEASURES: Trained observers followed interns during a "call" day. The observers continuously recorded the tasks performed by interns, using customized task analysis software. We measured the amount of time spent on each task. We calculated means and standard deviations for the amount of time spent on six categories of tasks: clinical computer work (e.g., writing orders and notes), non-patient communication, direct patient care (work done at the bedside), downtime, transit and teaching/learning. We also calculated means and standard deviations for time spent on specific tasks within each category. We compared the amount of time spent on the top three categories using analysis of variance.

KEY RESULTS: The largest proportion of intern time was spent in clinical computer work (40 %). Thirty percent of time was spent on non-patient communication. Only 12 % of intern time was spent at the bedside. Downtime activities, transit and teaching/learning accounted for 11 %, 5 % and 2 % of intern time, respectively.

CONCLUSION: Our results suggest that during on call periods, relatively small amounts of time are spent on direct patient care and teaching/learning activities. As intern duty hours continue to decrease, attention should be directed towards preserving time with patients and increasing time in education.

Author List

Fletcher KE, Visotcky AM, Slagle JM, Tarima S, Weinger MB, Schapira MM


Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Internal Medicine
Internship and Residency
Prospective Studies
Time and Motion Studies
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0