Council on Medical Student Education in Pediatrics


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Residents don't think they're learning during heavy inpatient service months
Perceptions of Educational Experience and Inpatient Workload Among Pediatric Resident
Haferbecker D et al. Hospital Pediatrics 2013;3;276
Reviewed by Amy Guiot, MD

What was the study question?
Does workload affect residents' perceptions of learning opportunities in an inpatient pediatric setting?

How was the study done?
Prospective cohort study conducted at Children's Hospital of Philadelphia October 2010-June 2011. Interns and seniors completed weekly surveys assessing perceptions of learning and ability to attend educational activities. Daily peak medical inpatient census data were collected.

What were the results?
The mean weekly survey response rate was 25%.
Among interns, all aspects of perceived learning were negatively correlated with perceived workload. With increased workload, residents missed more noon conferences, read less about their patients, and attended fewer educational conferences. Perceived learning regarding direct patient care was less affected by increased workload compared to learning from conferences and outside reading. Among seniors, perceived learning did not vary as workload increased.

What are the implications of this study?
For interns, increased workload negatively impacts perceived learning especially not related to inpatient care. As educators, we need to assess what outside educational activities to offer and how often these outside activities should be provided which would most benefit these very busy interns during times of high census.

Editor's note: What is teaching? What is learning? In the absence of measures of those phenomenon it is difficult to know whether residents learn better from heavy service months where they may miss didactic conferences or lighter months with less patient care responsibilities and a greater ability to attend those conferences. Perhaps limiting didactic time during busy months and focusing on learning from direct patient care instead would ease residents' perceptions of having missed learning opportunities.(RR)

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