title: Impact of Attending Physicians' Comments on Residents' Workloads in the Emergency Department: Results from Two J(^o^)PAN Randomized Controlled Trials.
abstract: OBJECTIVE
  To examine whether peppy comments from attending physicians increased the workload of residents working in the emergency department (ED).
  
  
  METHODS
  We conducted two parallel-group, assessor-blinded, randomized trials at the ED in a tertiary care hospital in western Japan. Twenty-five residents who examined either ambulatory (J(^o^)PAN-1 Trial) or transferred patients (J(^o^)PAN-2 Trial) in the ED on weekdays. Participants were randomly assigned to groups that either received a peppy message such as "Hope you have a quiet day!" (intervention group) or did not (control group) from the attending physicians. Both trials were conducted from June 2014 through March 2015. For each trial, residents rated the number of patients examined during and the busyness and difficulty of their shifts on a 5-point Likert scale.
  
  
  RESULTS
  A total of 169 randomizations (intervention group, 81; control group, 88) were performed for the J(^o^)PAN-1 Trial, and 178 (intervention group, 85; control group, 93) for the J(^o^)PAN-2 Trial. In the J(^o^)PAN-1 trial, no differences were observed in the number of ambulatory patients examined during their shifts (5.5 and 5.7, respectively, p = 0.48), the busyness of their shifts (2.8 vs 2.8; p = 0.58), or the difficulty of their shifts (3.1 vs 3.1, p = 0.94). However, in the J(^o^)PAN-2 trial, although busyness (2.8 vs 2.7; p = 0.40) and difficulty (3.1 vs 3.2; p = 0.75) were similar between groups, the intervention group examined more transferred patients than the control group (4.4 vs 3.9; p = 0.01).
  
  
  CONCLUSIONS
  Peppy comments from attending physicians had a minimal jinxing effect on the workload of residents working in the ED.
  
  
  BACKGROUND
  University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000017193 and UMIN000017194.
authors.affiliation: Department of General Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kuriyama
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Umakoshi
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Fujinaga
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Toshie
authors.initials: T
authors.lastname: Kaihara
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Urushidani
authors.affiliation: Department of General Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kuninaga
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ichikawa
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ienaga
authors.affiliation: Department of General Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
authors.forename: Tetsunori
authors.initials: T
authors.lastname: Ikegami
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007564:Japan; D005791:Patient Care / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data*