Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan

Background: Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients’ bedsides remains unexplored. Objective: To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan. Design: Nationwide multicenter cross-sectional study. Participants: First- and second-year postgraduate residents who took the General Medicine In-Training Examination at the end of the 2022 academic year. Interventions: Time-at-bedside was defined as the average time per day the residents spend providing care at patients’ bedsides during their residency. Time-at-bedside was classified into six categories: C1 (10–20 min per day), C2 (30–50 min per day), C3 (60–80 min per day), C4 (90–110 min per day), C5 (120–140 min per day), and C6 (150 min or more per day). Data on time-at-bedside were collected through an electronic survey conducted immediately after the General Medicine In-Training Examination. Main Measures: The primary outcome was the General Medicine In-Training Examination score. A multi-level analysis examined the association between self-reported time-at-bedside and the General Medicine In-Training Examination score. Key Results: A total of 5344 residents were included in this study. Of these, 2760 were first-year residents, and 2584 were second-year residents. Of the 5334 residents, 66.9% reported spending less than 60 min at a patient’s bedside. Compared to the C1, C2 (adjusted score difference [aSD] = 1.1, 95% confidence interval [95% CI] 0.48 to 1.79), C3 (aSD = 1.5, 95% CI 0.75 to 2.20), and C5 (aSD = 2.0, 95 CI 0.62 to 3.38) were positively associated with the General Medicine In-Training Examination score. However, C4 (aSD = 1.1, 95% CI − 0.15 to 2.26) and C6 (aSD = 0, 95% CI − 1.79 to 1.87) were not associated with the General Medicine In-Training Examination score. Conclusion: Self-reported time-at-bedside positively correlates with in-training examination scores among Japanese resident physicians.