B. Zhao1, J. Lam1, A. Lee1, G. R. Jacobsen1 1University Of California – San Diego,Surgery,San Diego, CA, USA
Introduction:
Duty-hour limits continue to be an important topic in graduate medical education. Currently, the majority of programs rely in voluntary reporting of duty-hours by trainees. The accuracy of reported hours can be poor because tracking work-hours can be an arduous task for trainees. This can lead to trainees not regularly reporting hours, which can further decrease the accuracy of reported work-hours. In this study, we propose an innovative method to track trainee work-hours using a smartphone app.
Methods:
We performed a pilot study testing the feasibility of an automated, location-based time-keeping smartphone app on 10 general surgery residents at our institution. The app sets “geofences” around specific locations and automatically records work-hours once the user is within the “geofenced” area. Study personnel installed the app on each participants’ smartphones and instructed participants on how to check their work-hours using the app. A hypothetical work-hour record is shown in the Figure. We conducted a pre-installation survey and a post-installation survey 12 weeks later.
Results:
Prior to using the app, 80% of residents stated that it was too time-consuming to report hours and 40% of residents stated that it was difficult to accurately track duty-hours. 60% of residents thought they were under-reporting their duty-hours prior to using the app. However, after using the app, only 1 resident stated that he or she worked more than they previously thought. The frequency of hours-reporting did not change after using the app, with half of the residents stating that they reported hours less frequently than once per month in both surveys. In terms of usability, 80% of residents stated that the app was moderately easy to use and 60% stated that it was moderately accurate. 80% of residents actively used the app to check their duty-hours. Two residents complained that the app was slow to clock-out at times, leading to over-counting of work-hours, and two residents complained that the app was detrimental to their phone’s battery life. After using the app, 60% of residents stated that they were at least moderately likely to allow a location-based app to automatically report their work-hours in the future.
Conclusion:
Using a location-based time-keeping smartphone app has potential to help residents track duty-hours. The app works in the background and allows residents easy access to their duty-hours. Further work needs to be done to improve the accuracy of the app and further integrate the app with the reporting of duty-hours. This will decrease the burden, and increase the accuracy, of duty-hour reporting for trainees.
