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Letters |

Faculty Misperceptions About How Residents Spend Their Call Nights

Kalpana Chalasani, MD; Mary D. Nettleman, MD, MS; Shelly Smith Moore, MS, AdEd; Sandy MacArthur, MD; Rollin J. Fairbanks, MD; Munish Goyal, MD
[+] Author Affiliations

Stephen J. Lurie, MD, PhDSenior Editor: IndividualAuthor
Jody W. Zylke, MDContributing Editor: IndividualAuthor

Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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JAMA. 2001;286(9):1024-1024. doi:10-1001/pubs.JAMA-ISSN-0098-7484-286-9-jlt0905
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To the Editor: Although house staff night call contains important educational activities, it also is a time-consuming and potentially stressful experience. Faculty usually are not present at night to observe house staff activities and may misjudge the time required to perform nighttime duties. However, faculty have significant influence on the design of house staff programs and are the principal evaluators of house staff. Therefore, we performed a survey of faculty to evaluate knowledge of house staff on-call activities.

METHODS

An anonymous survey was given to general internal medicine and pediatric faculty at Virginia Commonwealth University School of Medicine. The results of the surveys were compared with a time-motion study that directly measured actual duration of activities during night call.1

RESULTS

Response rates were 80% (20/25) for internal medicine and 85% (17/20) for pediatric faculty. Faculty estimates often differed from the results of the time-motion study (Table 1). On average, faculty thought that residents spent more than twice as much time on direct patient care than was actually observed, and they tended to underestimate how much time residents spent on documentation and discussions with team members. Furthermore, faculty significantly underestimated the amount of free time during night call.

Table Grahic Jump LocationTable. Survey Results vs Time-Motion Study for Residents During Night Call

COMMENT

Attending faculty physicians in this sample did not have an accurate perception of resident on-call activities. This misperception appeared equally true of both internal medicine and pediatric faculty. Faculty thought that residents spent far more time on direct patient care and had far less down time than was actually the case. As 1 survey respondent stated, "residents simply stay up all night seeing patient after patient."

Faculty physicians are responsible for the evaluation and design of clinical rotations and have a major voice in graduate medical education reform. Our results show that a more accurate understanding of these activities may be needed to paint a realistic picture of night call.

REFERENCES

Moore  SS, Nettleman  MD, Beyer  S.  et al.  How residents spend their nights on call. Acad Med. 2000;75:1021-1024.

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Table Grahic Jump LocationTable. Survey Results vs Time-Motion Study for Residents During Night Call

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Moore  SS, Nettleman  MD, Beyer  S.  et al.  How residents spend their nights on call. Acad Med. 2000;75:1021-1024.
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