Brasel Karen J, Pierre Amy L, Weigelt John A
Department of Surgery, Medical College of Wisconsin, Milwaukee, 53226, USA.
Arch Surg. 2004 May;139(5):490-3; discussion 493-4. doi: 10.1001/archsurg.139.5.490.
We attempted to better quantitate resident work within our system of care.
Survey.
Academic training program.
Surgical residents.
A work-hour survey was developed defining 5 areas of activity: patient care related to educational objectives, required educational activities, patient care activities unrelated to educational objectives, off-duty educational activity, and off-duty hours.
Total work hours and noneducational work hours were analyzed by resident level, rotation, and category.
The survey response rate was 52%, covering 110 workweeks. Residents worked 80 hours or less for 57 weeks and more than 80 hours for 53 weeks. The mean number of hours worked was 77. Fewer than one quarter (21.9%) of work hours were unrelated to educational activities. The amount of time spent in noneducational activities was lowest at community hospitals (17%) and similar at the Veterans Affairs (23%) and academic (22%) medical centers. It did not vary by total hours worked, averaging 21% for rotations of more than 80 h/wk and 23% for rotations of 80 h/wk or less.
Residents spend a large amount of time in noneducational activities. Eliminating these activities would bring our rotations into compliance with the 80-hour workweek. It would also generate a large amount of time for educational activities within our training program.
我们试图在我们的医疗体系中更好地量化住院医师的工作。
调查。
学术培训项目。
外科住院医师。
开展了一项工作时间调查，定义了5个活动领域：与教育目标相关的患者护理、所需的教育活动、与教育目标无关的患者护理活动、非值班教育活动和非值班时间。
按住院医师级别、轮转和类别分析总工作时间和非教育工作时间。
调查回复率为52%，涵盖110个工作周。住院医师在57周内工作80小时或更少，在53周内工作超过80小时。平均工作小时数为77小时。与教育活动无关的工作时间不到四分之一（21.9%）。在社区医院，用于非教育活动的时间最少（17%），在退伍军人事务医疗中心（23%）和学术医疗中心（22%）相似。它不会因总工作小时数而有所不同，每周工作超过80小时的轮转平均为21%，每周工作80小时或更少的轮转平均为23%。
住院医师在非教育活动上花费大量时间。消除这些活动将使我们的轮转符合每周80小时的工作时长规定。这也将为我们培训项目中的教育活动腾出大量时间。
