Training for efficiency: work, time, and systems-based practice in medical residency.

TitleTraining for efficiency: work, time, and systems-based practice in medical residency.
Publication TypeJournal Article
Year of Publication2012
AuthorsSzymczak JE, Bosk CL
JournalJ Health Soc Behav
Volume53
Issue3
Pagination344-58
Date Published2012 Sep
ISSN2150-6000
KeywordsAdaptation, Psychological, Efficiency, Humans, Internal Medicine, Internship and Residency, Socialization, Time Factors, Time Management, United States, Workload
Abstract

Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at three training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable "systems" problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities.

DOI10.1177/0022146512451130
Alternate JournalJ Health Soc Behav
PubMed ID22863601
PubMed Central IDPMC3886114
Grant List5R01HL094593-03 / HL / NHLBI NIH HHS / United States
R01 HL094593 / HL / NHLBI NIH HHS / United States