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Journal of Medical Education

以「時間研究法」探討某醫學中心心臟內科實習及住院醫師之臨床訓練

Abstract

Objectives: To study the workload of interns and residents in the Cardiology department of a medical center and examine how the workload varies with training level or day-night shift. Methods: A time study was used to record the daily activity of 24 interns and residents. Results: A total of 144 daily work-sheets were prepared and distributed to appropriate staff, and 102 were returned. Excluding two incomplete sheets, data collected from 100 work sheets were used. (1) Residents worked an average of 64.6 hours a week. Significant difference in weekly working hours between interns or residents was not seen (p = 0.6161). (2) The daily working hours were 12.5 hours for R12, this figure decreasing to 10.9 hours for R456, although it not revealing any statistically-significant difference (p = .3409). Although primary patient care constituted the major workload activity (8.2 hours), care activities varied with the different professional levels of interns and residents. (3) Night shift (14.7 hours) was a significantly longer shift than day shift (10.3 hours) (P＜0.0001). (4) Interns provided inpatient service 0.64 hours per inpatient per day. Residents provided 0.42-0.7 hours per inpatient per day, the figure increasing with the resident’s professional level. (5) Residents only received six minutes of bedside teaching per inpatient per day. Conclusion: Primary care was the major activity for cardiology interns and residents. They began day shift immediately following the nigh shift and the day shift was thus usually overtime. The long hours’ work was not only just stressful but also would be likely to have affected the quality of patient care. Our findings suggested the traditional program of intern and resident training should be reformed.

First Page

197

Last Page

207

DOI

10.6145/jme.200109_5(3).0003

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