Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan.

Abstract

Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients' bedsides remains unexplored. To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan. Nationwide multicenter cross-sectional study. First- and second-year postgraduate residents who took the General Medicine In-Training Examination at the end of the 2022 academic year. Time-at-bedside was defined as the average time per day the residents spend providing care at patients' bedsides during their residency. Time-at-bedside was classified into six categories: C1 (10-20 min per day), C2 (30-50 min per day), C3 (60-80 min per day), C4 (90-110 min per day), C5 (120-140 min per day), and C6 (150 min or more per day). Data on time-at-bedside were collected through an electronic survey conducted immediately after the General Medicine In-Training Examination. The primary outcome was the General Medicine In-Training Examination score. A multi-level analysis examined the association between self-reported time-at-bedside and the General Medicine In-Training Examination score. A total of 5344 residents were included in this study. Of these, 2760 were first-year residents, and 2584 were second-year residents. Of the 5334 residents, 66.9% reported spending less than 60 min at a patient's bedside. Compared to the C1, C2 (adjusted score difference [aSD] = 1.1, 95% confidence interval [95% CI] 0.48 to 1.79), C3 (aSD = 1.5, 95% CI 0.75 to 2.20), and C5 (aSD = 2.0, 95 CI 0.62 to 3.38) were positively associated with the General Medicine In-Training Examination score. However, C4 (aSD = 1.1, 95% CI - 0.15 to 2.26) and C6 (aSD = 0, 95% CI - 1.79 to 1.87) were not associated with the General Medicine In-Training Examination score. Self-reported time-at-bedside positively correlates with in-training examination scores among Japanese resident physicians.