title: The composition of intern work while on call.
abstract: BACKGROUND
  The work of house staff is being increasingly scrutinized as duty hours continue to be restricted.
  
  
  OBJECTIVE
  To describe the distribution of work performed by internal medicine interns while on call.
  
  
  METHODS
  Prospective time motion study on general internal medicine wards at a VA hospital affiliated with a tertiary care medical center and internal medicine residency program.
  
  
  METHODS
  Internal medicine interns.
  
  
  METHODS
  Trained observers followed interns during a "call" day. The observers continuously recorded the tasks performed by interns, using customized task analysis software. We measured the amount of time spent on each task. We calculated means and standard deviations for the amount of time spent on six categories of tasks: clinical computer work (e.g., writing orders and notes), non-patient communication, direct patient care (work done at the bedside), downtime, transit and teaching/learning. We also calculated means and standard deviations for time spent on specific tasks within each category. We compared the amount of time spent on the top three categories using analysis of variance.
  
  
  RESULTS
  The largest proportion of intern time was spent in clinical computer work (40 %). Thirty percent of time was spent on non-patient communication. Only 12 % of intern time was spent at the bedside. Downtime activities, transit and teaching/learning accounted for 11 %, 5 % and 2 % of intern time, respectively.
  
  
  CONCLUSIONS
  Our results suggest that during on call periods, relatively small amounts of time are spent on direct patient care and teaching/learning activities. As intern duty hours continue to decrease, attention should be directed towards preserving time with patients and increasing time in education.
authors.affiliation: Clement J. Zablocki VAMC, Milwaukee, WI, USA. Kathlyn.fletcher@va.gov
authors.forename: Kathlyn E
authors.initials: KE
authors.lastname: Fletcher
authors.forename: Alexis M
authors.initials: AM
authors.lastname: Visotcky
authors.forename: Jason M
authors.initials: JM
authors.lastname: Slagle
authors.forename: Sergey
authors.initials: S
authors.lastname: Tarima
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Weinger
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Schapira
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D013996:Time and Motion Studies; D016526:Workload / Q000706:statistics & numerical data*