How surgical residents spend their training time: the effect of a goal-oriented work style on efficiency and work satisfaction.

HYPOTHESIS When work hours are limited, improving residents' work efficiency allows more time for key training activities, reduces frustration, and improves work satisfaction. DESIGN Prospective control study. SETTING General surgical service with a trauma program. PARTICIPANTS Five full-time attending physicians, a resident team of 9 members, and 3 surgical assistants. INTERVENTION 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. RESULTS 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. CONCLUSIONS Residents' work is generally inefficient. Reduced work hours should be accompanied by work-habit reform to make the best use of residents' training time.