摘要：Background: Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also
comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload
arising from increased patient care interferes with student supervision and is associated with more non-medical
activities of final-year medical students.
Methods: A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period
at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and nonmedical - according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity
themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities
reported on a particular day were matched with a ward specific workload-index derived from the hospital information
system, including the number of patients treated on the corresponding ward on that day, a correction factor according
to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and
ward residents were blinded to the study question.
Results: A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ±
1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were
reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward
specific workload and number of medical activities could be shown.
Conclusions: There was a significant association between ward doctors’ supervision of students and the number of
medical activities performed by medical students. The workload had no significant effect on supervision or the number
of medical or non-medical activities of final-year students.
