A preliminary exploration of time management strategies used by physicians in the United States

Olga Kleshinski1, Thomas G. Dunn1 and James F. Kleshinski2

1Department of Educational Psychology, Research and Social Foundations, The University of Toledo College of Education, USA

2Department of Medicine, The University of Toledo College of Medicine, USA

Submitted: 04/05/2010; Accepted: 24/06/2010; Published: 29/06/2010

Int J Med Educ. 2010; 1:47-54; doi: 10.5116/ijme.4c23.117d

© 2010 Olga Kleshinski et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: To investigate time management strategies used by experienced physicians, how they are acquired, and to what extent they are supported by tacit knowledge.

Methods: Five physicians, each with more than ten years of clinical experience, participated. Data were collected during three medical office observations and two in-depth interviews with each physician. The purpose of observations was to monitor events that had time management implications. The interviews consisted of 1) a stimulated recall procedure during which physicians were asked questions aimed at capturing, retrospectively, contents of working memory at a particular moment during an observed event with time management implications 2) questions that encouraged physicians to talk about the time issues they face in practice, what time management strategies they use, and how they developed these strategies.

Results: Physicians implemented many strategies that helped them manage time efficiently. These strategies were supported by explicit and tacit knowledge. Instances of tacit knowledge use were automatic with little conscious deliberation. Inferences were made as to the specific knowledge supporting these instances.

Conclusions: The identified explicit strategies provided concrete examples of how physicians can circumvent time limitations and, since being explicit, could be included in undergraduate and graduate medical education and taught by direct instruction. Regarding strategies supported by tacit knowledge, the use of advice strategies was recommended to help novice physicians learn this tacit knowledge as opposed to direct instruction. Encouraging results presented here provide practical ideas on how medical professionals can circumvent time limitations in a busy clinical practice.