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Impact of scribe utilization on resident education and fatigue mitigation

Published:February 28, 2018DOI:https://doi.org/10.1016/j.ajem.2018.02.028
      Physicians experience higher rates of burnout compared to the general population, and many times the origin of the burnout can be traced to residency training [
      • Eckleberry-Hunt J.
      • Lick D.
      • Boura J.
      • et al.
      An exploratory study of resident burnout and wellness.
      ]. Burnout may be the precursor to many subsequent mental and physical ailments including depression, substance abuse, social isolation, anxiety, self-blame for negative outcomes and even suicide [
      • Eckleberry-Hunt J.
      • Lick D.
      • Boura J.
      • et al.
      An exploratory study of resident burnout and wellness.
      ,
      • Eva Schernhammer
      Taking-their-own-lives-the-high-rate-of-physician-suicide.
      ,
      • Riley G.J.
      On being a doctor-understanding the stresses and strains of being a doctor.
      ,
      • Shanafelt T.D.
      • Sloan J.A.
      • Habermann T.M.
      The well-being of physicians.
      ,
      • West C.P.
      • Huschka M.M.
      • Novotny P.J.
      • et al.
      Association of perceived medical errors with resident distress and empathy.
      ,
      • Arnetz B.B.
      Psychosocial challenges facing physicians of today.
      ,
      • Meier D.E.
      The inner life of physicians and care of the seriously ill.
      ]. Furthermore, physician burnout has a high societal cost and can lead to lower quality patient care [
      • Eckleberry-Hunt J.
      • Lick D.
      • Boura J.
      • et al.
      An exploratory study of resident burnout and wellness.
      ,
      • Firth-Cozens J.
      • Greenhalgh J.
      Doctors' perceptions of the links between stress and lowered clinical care.
      ]. Surveys of physicians have shown that doctors trace work stress to the consistently experienced high intensity of work, conflicting time demands, heavy professional responsibilities, limited control over work requirements, ever present medico-legal concerns, and systemic-paucity of physical and social resources [
      • Riley G.J.
      On being a doctor-understanding the stresses and strains of being a doctor.
      ].
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      References

        • Eckleberry-Hunt J.
        • Lick D.
        • Boura J.
        • et al.
        An exploratory study of resident burnout and wellness.
        Acad Med. 2009; 84: 269-277https://doi.org/10.1097/ACM.0b013e3181938a45
        • Eva Schernhammer
        Taking-their-own-lives-the-high-rate-of-physician-suicide.
        N Engl J Med. 2005; 352
        • Riley G.J.
        On being a doctor-understanding the stresses and strains of being a doctor.
        Med J Aust. 2004; 181 ([doi:ril10433_fm [pii]): 25-729
        • Shanafelt T.D.
        • Sloan J.A.
        • Habermann T.M.
        The well-being of physicians.
        Am J Med. 2003; 114: 513-519https://doi.org/10.1016/S0002-9343(03)00117-7
        • West C.P.
        • Huschka M.M.
        • Novotny P.J.
        • et al.
        Association of perceived medical errors with resident distress and empathy.
        JAMA. 2006; 296: 1071https://doi.org/10.1001/jama.296.9.1071
        • Arnetz B.B.
        Psychosocial challenges facing physicians of today.
        Soc Sci Med. 2001; 52: 203-213https://doi.org/10.1016/S0277-9536(00)00220-3
        • Meier D.E.
        The inner life of physicians and care of the seriously ill.
        JAMA. 2001; 286: 3007https://doi.org/10.1001/jama.286.23.3007
        • Firth-Cozens J.
        • Greenhalgh J.
        Doctors' perceptions of the links between stress and lowered clinical care.
        Soc Sci Med. 1997; 44: 1017-1022https://doi.org/10.1016/S0277-9536(96)00227-4
        • Hripcsak G.
        • Vawdrey D.K.
        • Fred M.R.
        • Bostwick S.B.
        Use of electronic clinical documentation: time spent and team interactions.
        J Am Med Inform Assoc. 2011; 18: 112-117https://doi.org/10.1136/jamia.2010.008441
        • Ammenwerth E.
        • Spotl H.P.
        The time needed for clinical documentation versus direct patient care - a work-sampling analysis of physicians' activities.
        Methods Inf Med. 2009; 48: 84-91https://doi.org/10.3414/ME0569
        • Oxentenko A.S.
        • West C.P.
        • Popkave C.
        • Weinberger S.E.
        • Kolars J.C.
        Time spent on clinical documentation a survey of internal medicine residents and program directors.
        Arch Intern Med. 2010; 170
        • Shanafelt T.D.
        • Dyrbye L.N.
        • Sinsky C.
        • et al.
        Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction.
        Mayo Clin Proc. 2016; https://doi.org/10.1016/j.mayocp.2016.05.007
        • Koshy S.
        • Feustel P.J.
        • Hong M.
        • Kogan B.A.
        Scribes in an ambulatory urology practice: patient and physician satisfaction.
        J Urol. 2010; 184: 258-262https://doi.org/10.1016/j.juro.2010.03.040
        • Hess J.J.
        • Wallenstein J.
        • Ackerman J.D.
        • et al.
        Scribe impacts on provider experience, operations, and teaching in an academic emergency medicine practice.
        West J Emerg Med. 2015; 16: 602-610https://doi.org/10.5811/westjem.2015.6.25432
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • Payne J.
        • Gonzalez N.
        • Conde J.G.
        Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381https://doi.org/10.1016/j.jbi.2008.08.010
        • Antiel R.M.
        • Thompson S.
        • Reed D.A.
        • et al.
        ACGME duty-hour recommendations - a national survey of residency program directors.
        N Engl J Med. 2010; 363e12