When work hours are limited, improving residents' work efficiency allows more time for key training activities, reduces frustration, and improves work satisfaction.
Prospective control study.
General surgical service with a trauma program.
Five full-time attending physicians, a resident team of 9 members, and 3 surgical assistants.
Reorganization of work habits based on a goal-oriented work style.
Main Outcome Measures
Changes of time spent in key activities; punctuality for operations, clinics, and conferences; residents' work satisfaction, physical fatigue, and mental stress; and attending physician and patient evaluations of residents.
A goal-oriented work style reduced round time and nonpurposeful time and improved punctuality for key education activities. More operative time could be accommodated within the work-hours limits. Residents' work satisfaction improved while mental stress was reduced. Patient satisfaction scores also increased.
Residents' work is generally inefficient. Reduced work hours should be accompanied by work-habit reform to make the best use of residents' training time.