Impact of medical student teaching on family physicians' use of time.

BACKGROUND

The purpose of this study was to determine how much and in what ways family physicians' time at work is affected by the presence of a medical student in the practice.

METHODS

The study included work sampling of 22 non-academic family physicians, each observed during 1 day with and 1 day without a medical student, and 12 academic family physicians, of whom nine were observed for 8 half-days and three for 2 or 4 half-days of clinical practice. Observations were made on average every 4 minutes at preselected random times during the workday.

RESULTS

When a student was present at the practice, the amount of time private physicians actually spent working increased by 52 minutes per day, and their patient-care productivity decreased from 3.9 to 3.3 patients per hour. There was no significant change in time spent at work for academic physicians. With a student present, the physicians in private practice spent 27 fewer minutes per day in patient-care activities, whereas academic physicians spent 47.5 fewer minutes per day in these activities. Private and academic physicians spent 71 and 63 minutes per day, respectively, in student-centered activities. There were few differences between physician groups in how this direct teaching time was used.

CONCLUSIONS

When a student is in the practice, private family physicians shift substantial amounts of work time from patient-centered to student-centered activities. They also use their personal time for teaching activities and experience a decrease in patient-care productivity of 0.6 patients per hour.