Strategies for Teaching Residents who Struggle with Time Management by Carly McAteer, MD

Skill with time management and organization is essential for residents who are typically burdened with a large number of patient care, educational, and administrative tasks.  When a resident is struggling, it can be difficult to determine the particular cause.1  Residents who struggle with time management and organization present themselves by often being unprepared for deadlines, assignments, and patient rounds.  These residents can appear disorganized in appearance, shuffle through multiple documents while presenting at rounds, and often keep patients waiting while running behind.1  When it is determined that a resident is struggling with time management, some helpful strategies are:

  • Assess time-logs of how the resident spends his or her time. These can be kept either by the resident or by someone performing direct observation.1
  • Discuss goals and expectations with the resident. An example of this would be reviewing how much time you expect specific tasks to require to be completed. (I.e. “It should take you about 10 minutes or less to write a progress note.”)1
  • Assist the resident in creating a data organization system. Examples of this could be using a to-do list app on their smartphone or creating note templates for different types of patient encounters.  Spending time developing filing systems and adhering to the “touch each paper once” rule can help minimize wasted time.2
  • Deconstruct tasks. Breaking down tasks into their most granular and reproducible components can help struggling residents who are not sure what task to complete first.4
  • Help the learner practice prioritizing. Constructs such as Covey’s Time Management Matrix Technique where tasks are divided into 4 categories can help struggling residents decipher which task is the most important to complete next.3  For example:
Urgent /Important

Page from nurse about patient in respiratory distress

Urgent /Less Important

Patient phone calls

Refill requests

Less Urgent/Important

Complete documentation of patient encounters

Less Urgent/Less Important

Routine committee meeting

  • Assist the resident with planning and organizing activities. Reviewing common tasks and schedules can help create daily, weekly, or monthly schedules that maximize time allotted.3  For example, if a resident knows he or she is most efficient with documentation in the early morning, recommending going to bed earlier and getting up to complete appropriate documentation in the morning can maximize efficiency.

References:

Guerrasio, Jeannette. Remediation of the Struggling Medical Learner.  2nd edition. LaVergne, TN: 2018.

Allen, David.  Getting Things Done: The Art of Stress-Free Productivity.  New York, NY: 2001.

Gordon CE, et al. Recapturing time: a practical approach to time management for physicians.  Postgrad Med J 2014; 90:267-272.

DeKosky, et al. Simple Frameworks for Daily Work: Innovative Strategies to Coach Residents Struggling with Time Management, Organization, and Efficiency. J Grad Med Educ. 2018; 10(3) 325-330.

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