Workload: Was and colleagues, at Stanford Children’s Hospital, used a research database to determine the number of notes an intern wrote and the number of orders they placed for each of 6 core rotations. The authors proposed that comparing the number of notes written and orders entered by one intern to the average of their peers for each rotation would be a marker for workload intensity. Not surprisingly, they found that there were statistically significant differences in the number of notes and orders for different rotations (such as general floor versus a subspecialty rotation). They did not find any correlation between an intern’s perceived workload (their “cloud”) and actual intensity of work as described by the number of orders and notes. Of interest in pediatrics, there was little seasonal variation in workload intensity between the fall/winter and spring/summer.
This estimate of workload intensity does not capture the quality or complexity of the work or the time required to complete it, limiting its applicability to an individual intern. It may, however, offer program directors an objective method of describing how hard or busy one rotation is compared to another. In regard to an intern’s “cloud”, the more interesting comparison would have been the perception of an intern’s workload by their colleagues compared to workload intensity. — Michael J. Kelly, MD