title: Use of a personal digital assistant to monitor surgery student work and sleep hours.
abstract: BACKGROUND
  We developed a personal digital assistant (PDA)-based program to assess compliance with our medical student work hours policy, and to correlate work hours with sleep and performance.
  
  
  METHODS
  Medical students on surgery clerkship logged real-time work and sleep hours for 1 week. Estimated work hours, clinical evaluations, and score on the National Board of Medical Examiners (NBME) surgery examination were recorded.
  
  
  RESULTS
  Thirty-seven students logged work hours, which correlated poorly with estimated work hours and sleep hours. The majority of students overestimated work hours by a mean of 19.5 hours. Twenty-four students transgressed written policy. Increased in-hospital study hours correlated with improved clinical ratings but poorer NBME examination scores. Increased operating room hours correlated with higher NBME examination scores.
  
  
  CONCLUSIONS
  Medical students inaccurately estimate work hours; a PDA-based log facilitates hours monitoring. Unenforced work hour policies are frequently transgressed. Work activity patterns, but not total work hours, correlated with outcomes on standardized written tests and clinical ratings.
authors.affiliation: Department of Surgery, University of Hawaii John A. Burns School of Medicine, 1356 Lusitana St., Sixth Floor, Honolulu, HI 96813, USA. steine@hawaii.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Steinemann
authors.forename: Jill
authors.initials: J
authors.lastname: Omori
mesh_terms: D002982:Clinical Clerkship; D034201:Computers, Handheld; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D012890:Sleep; D013337:Students, Medical; D014481:United States; D014937:Work