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How Should Residents Spend Their Time?

Tue, 05/06/2014 - 10:38am
Skeptical Scalpel

As everyone knows, residents are now restricted to working 80 hours per week. One of the lesser known side effects of this work hours limitation is the drastic loss of educational conference time.

Since at least one third of the residents must now go home after morning rounds, afternoon conferences are no longer possible. Most residency programs now devote part of at least one morning per week to dedicated educational time.

A new paper from JAMA Surgery describes how one program chose to comply with the mandate to teach some of the more fuzzy resident core competencies. Their weekly didactic schedule of 1 hour of grand rounds and 1 hour of small group learning now includes 10 hours per year [representing 10% of the 100 hours allotted to formal teaching] on practice-based learning and improvement, interpersonal and communication skills, systems-based practice, and professionalism.

From the paper's Table 3, the specific topics are structure and policy of US health care, advocacy, medical economics and finance, history and consequences of major legislation, innovation in health care, health information technology, comparative effectiveness, health care disparities, basic management principles, quality, performance improvement, patient safety, coding and billing compliance, legal issues, litigation, risk management, clinical practice models, contracts, relative value units (RVUs), personal leadership styles, power and influence: organization psychology, negotiation and conflict resolution, communication, ethics, and last but certainly not least, one of my favorites—Six Sigma. [What, no mention of "Lean"?]

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