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. 2017 Jun 30;8(3):e49-e70.
eCollection 2017 Jun.

Time is of the essence: an observational time-motion study of internal medicine residents while they are on duty

Cameron W Leafloor  1 , Erin Yiran Liu  2 , Catherine C Code  1   3 , Heather A Lochnan  1   4   5 , Erin Keely  1   4   5 , Deanna M Rothwell  2 , Alan J Forster  1   2   3   5 , Allen R Huang  1   5   6
Affiliations

Time is of the essence: an observational time-motion study of internal medicine residents while they are on duty

Cameron W Leafloor et al. Can Med Educ J. .

Abstract

Background: The effects of changes to resident physician duty hours need to be measureable. This time-motion study was done to record internal medicine residents' workflow while on duty and to determine the feasibility of capturing detailed data using a mobile electronic tool.

Methods: Junior and senior residents were shadowed by a single observer during six-hour blocks of time, covering all seven days. Activities were recorded in real-time. Eighty-nine activities grouped into nine categories were determined a priori.

Results: A total of 17,714 events were recorded, encompassing 516 hours of observation. Time was apportioned in the following categories: Direct Patient Care (22%), Communication (19%), Personal tasks (15%), Documentation (14%), Education (13%), Indirect care (11%), Transit (6%), Administration (0.6%), and Non-physician tasks (0.4%). Nineteen percent of the education time was spent in self-directed learning activities. Only 9% of the total on duty time was spent in the presence of patients. Sixty-five percent of communication time was devoted to information transfer. A total of 968 interruptions were recorded which took on average 93.5 seconds each to service.

Conclusion: Detailed recording of residents' workflow is feasible and can now lead to the measurement of the effects of future changes to residency training. Education activities accounted for 13% of on-duty time.

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Conflict of interest statement

Conflicts of interest: All authors report no conflicts of interest.

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Figure 1
Figure 1
Screenshot of the data capture tool application
Figure 2
Figure 2
Screenshot of the data capture tool recording a task interruption
Figure 3
Figure 3
Total hours and percentages of time spent in each of the categories of tasks
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See this image and copyright information in PMC

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