We commend Oxentenko and colleagues1 on their study demonstrating the excessive burden of clerical work reported by internal medicine residents. The recognition of this important topic and the effort to assess the educational value of these tasks is critical to ensuring that future residency reforms focus not just on hours worked but also on the type of work residents do.2 The authors identify faculty feedback as one factor that may add value to clerical work. There may be other factors that could make house staff activities more or less useful. In fact, Dresselhaus and colleagues3 demonstrated that while house staff perceived direct patient care activities to be more educational than indirect care, the differences were smaller than one would anticipate (ie, a score of 66 for “performing initial history and physical” vs as score of 39 for “documentation” on a scale of 0 to 100).
Doll JA, Arora V. Time Spent on Clinical Documentation: Is Technology a Help or a Hindrance?. Arch Intern Med. 2010;170(14):1276–1277. doi:10.1001/archinternmed.2010.228
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