title: Impact of medical student teaching on family physicians' use of time.
abstract: 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.
authors.affiliation: Department of Family and Community Medicine, University of Missouri-Columbia 65212, USA. danv@fcm.missouri.edu
authors.forename: D C
authors.initials: DC
authors.lastname: Vinson
authors.forename: C
authors.initials: C
authors.lastname: Paden
authors.forename: A
authors.initials: A
authors.lastname: Devera-Sales
mesh_terms: D000553:Ambulatory Care; D004504:Education, Medical, Undergraduate; D004526:Efficiency; D005180:Faculty, Medical / Q000458:organization & administration; D005194:Family Practice / Q000193:education* / Q000458:organization & administration; D006801:Humans; D008923:Missouri; D010821:Physicians, Family / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D011331:Private Practice / Q000458:organization & administration; D013337:Students, Medical; D017748:Time Management