Quantifying a junior doctor’s working day in real-time: tasks, stress, and physiological responses

Abstract

Background: Previous research investigating a junior doctor’s (JD) working day has relied on retrospective methods and focuses on what happens on average. This study investigated the feasibility and acceptability of using real-time methods, with emphasis on what happens for individuals. Methods: A series of 10 case studies in JDs were carried out at a UK hospital. Stress (UWIST tense arousal items) and work tasks (self-report clinical categorisation tool) were measured every 90 minutes throughout 2 shifts on an electronic diary. Heart-rate was measured continuously. In addition, ward-round work tasks were observer-coded. Feasibility and acceptability were established via JD feedback and completion rates. Findings: All measures were deployed successfully and evaluated positively by participants. Self-report completion rates were high (79% of possible entries). Intra-individual variability in heart-rate, tasks and stress were observed in all participants and will be illustrated in case study examples. Discussion: This study confirmed both the acceptability to JDs and the feasibility of using real-time measures throughout their clinical working day. These methods can now be implemented to investigate theoretical determinants of individuals’ work stress in real time.