Document Detail


The on-call experience of interns in internal medicine. Medical Education Task Force of Henry Ford Hospital.
MedLine Citation:
PMID:  2241437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As part of an effort to examine the structure and content of our residency program in internal medicine, we assessed interns' activities on call to identify problems with workload scheduling, supervision, or learning. Eleven interns were observed continuously during a 34-hour on-call period. Interns averaged 5.6 hours at the bedside, with 57 minutes of that time under direct supervision of a resident or attending physician. Nearly half of new patient examinations continued after midnight despite a special night admission team that evaluated all patients admitted after 11 pm. The interns averaged 21 beeps per 30 hours. They slept an average of 2.5 hours with two interruptions. They read about their patients an average of 4 minutes during the 34-hour period. Most supervision was away from the bedside (82/139 minutes). Bedside supervision occurred predominantly during rounds (45/57 minutes). Attending physicians averaged only 12 minutes of bedside interaction with the intern. Many of these findings were unanticipated. Structural defects in the training program were defined and are being addressed. Other training programs should consider similar analyses before making fundamental changes.
Authors:
D Nerenz; H Rosman; C Newcomb; M B Bolton; G Heudebert; T Simmer; S Goldstein
Related Documents :
12414477 - Application of the medical knowledge general competency to emergency medicine.
12969837 - Psychotherapy competencies: development and implementation.
16735877 - The effect of work hour restrictions on the education of orthopaedic surgery residents.
1766297 - The learning curve in stapes surgery.
2040137 - Information workstations in clinical pathology.
19344447 - Examining the relationship between typical drinking behavior and 21st birthday drinking...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  150     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-26     Completed Date:  1990-12-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2294-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Henry Ford Hospital, Detroit, MI 48202.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Clinical Competence
Hospital Bed Capacity, 500 and over
Humans
Internal Medicine / education*
Internship and Residency / organization & administration*
Medical History Taking
Michigan
Personnel Staffing and Scheduling
Physical Examination
Reading
Time and Motion Studies*
Work Schedule Tolerance
Comments/Corrections
Comment In:
Arch Intern Med. 1991 Aug;151(8):1674   [PMID:  1872680 ]
Arch Intern Med. 1991 Jul;151(7):1458   [PMID:  2064503 ]
Arch Intern Med. 1991 Jul;151(7):1458   [PMID:  2064502 ]
Arch Intern Med. 1990 Nov;150(11):2246-8   [PMID:  2241433 ]
Arch Intern Med. 1991 Jul;151(7):1463   [PMID:  2064508 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Systemic therapy in metastatic colorectal cancer.
Next Document:  Misdiagnosis in patients with amyotrophic lateral sclerosis.