What do senior internal medicine residents do in their continuity clinics?

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Abstract
Objective: To describe the activities of second- and third-year internal medicine residents during their outpatient continuity clinics. Design: Descriptive observational study. Setting: Medical school-affiliated community hospital primary care clinic. Patients/participants: All second-year (n=15) and third-year (n=14) residents enrolled in the internal medicine training program were observed at one-minute intervals during their routine half-day continuity clinics. Measurements and main results: An average of 203 observations were recorded for each resident. The distribution of resident activities was as follows: 1) direct interaction with patients (29.5%); 2) charting or writing prescriptions (24.0%); 3) social interactions with staff (13.7%); 4) attending conferences or reviewing medical literature (9.4%); 5) waiting or transiting (8.2%); 6) ward responsibilities (4.9%); 7) reviewing cases with attending physician (4.4%); and 8) miscellaneous activities (4.9%). Analysis of variance procedures revealed that the following variables significantly (pConclusions: These results suggest that this senior resident continuity experience is clinically intensive, yet provides surprisingly infrequent direct resident supervision. Further analysis of the educational activities occurring on these half-days is necessary to judge whether they are quantitatively and qualitatively adequate.