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Relationship between Resident Workload and Self-Perceived Learning on Inpatient Medicine Wards: a Longitudinal Study
BMC Medical Education
  • Elizabeth M. Haney, Oregon Health & Science University
  • Christina Nicolaidis, Portland State University
  • Alan Hunter, Oregon Health & Science University
  • Benjamin K. Chan, Oregon Health & Science University
  • Thomas G. Cooney, Oregon Health & Science University
  • Judith L. Bowen, Oregon Health & Science University
Document Type
Publication Date
  • Residents (Medicine) -- United States,
  • Residents (Medicine) -- Education,
  • Medical education -- United States -- Longitudinal studies

Background: Despite recent residency workload and hour limitations, little research on the relationship between workload and learning has been done. We sought to define residents' perceptions of the optimal patient workload for learning, and to determine how certain variables contribute to those perceptions. Our hypothesis was that the relationship between perceived workload and learning has a maximum point (forming a parabolic curve): that either too many or too few patients results in sub-optimal learning.

Methods: Residents on inpatient services at two academic teaching hospitals reported their team and individual patient censuses, and rated their perception of their learning; the patient acuity; case variety; and how challenged they felt. To estimate maximum learning scores, linear regression models with quadratic terms were fit on learning score.

Results: Resident self-perceived learning correlated with higher acuity and greater heterogeneity of case variety. The equation of census versus learning score, adjusted for perception of acuity and case mix scores, showed a parabolic curve in some cases but not in others.

Conclusion: These data suggest that perceived resident workload is complex, and impacted by additional variables including patient acuity and heterogeneity of case variety. Parabolic curves exist for interns with regard to overall census and for senior residents with regard to new admissions on long call days.


Copyright 2006 Haney et al; licensee BioMed Central Ltd. Available at

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Citation Information
Haney, E.M, Nicolaidis, C., Hunter, AJ., Chan, B.K., Cooney, T.G., Bowen, 1.L. "Relationship between resident workload and self-perceived learning on inpatient medicine wards: a longitudinal study." BMC Medical Education. 2006, 6:35.