%0 Journal Article
%T Relationship between resident workload and self-perceived learning on inpatient medicine wards: a longitudinal study
%A Elizabeth M Haney
%A Christina Nicolaidis
%A Alan Hunter
%A Benjamin KS Chan
%A Thomas G Cooney
%A Judith L Bowen
%J BMC Medical Education
%D 2006
%I BioMed Central
%R 10.1186/1472-6920-6-35
%X Residents on inpatient services at two academic teaching hospitals reported their team and individual patient censuses, and rated their perception of their learning; the patient acuity; case variety; and how challenged they felt. To estimate maximum learning scores, linear regression models with quadratic terms were fit on learning score.Resident self-perceived learning correlated with higher acuity and greater heterogeneity of case variety. The equation of census versus learning score, adjusted for perception of acuity and case mix scores, showed a parabolic curve in some cases but not in others.These data suggest that perceived resident workload is complex, and impacted by additional variables including patient acuity and heterogeneity of case variety. Parabolic curves exist for interns with regard to overall census and for senior residents with regard to new admissions on long call days.The resident work-hour and patient volume restrictions adopted by the Accreditation Council for Graduate Medical Education (ACGME) reflect an increasing awareness of the relationship between service and education for residents in training[1]. The rationale behind these requirements (workload caps) is to provide a safe and productive learning environment. The appropriate relationship between service and learning in medical education has been long-debated and remains controversial [2-4]. Service and learning are not completely distinct within medical education, because the practice of medicine itself is a service[5]. Medical education relies on learning in the context of providing clinical service to the patient. However, over-emphasis on clinical service, at the expense of other educational opportunities (discussion, reading, conferences or lectures) may be detrimental. Few data exist on the relationship between workload and learning to inform decisions about the balance between service and learning. Currently residency programs and residency governing bodies (such as the Internal
%U http://www.biomedcentral.com/1472-6920/6/35