Susan Steinemann1, Jill Omori. 1. Department of Surgery, University of Hawaii John A. Burns School of Medicine, 1356 Lusitana St., Sixth Floor, Honolulu, HI 96813, USA. steine@hawaii.edu
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.
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.