How to Give Your Workload Policy SWAG: Creation of a Student Workload Advisory Group to Reduce Workload Hour Exceedances for Preclerkship Medical Students

PROBLEM: With evolving accreditation requirements, competing demands of medical students, and the national trend toward shortening the preclerkship curriculum, management of workload hours for preclerkship medical students is essential. Although many medical schools have established policies outlining student workload expectations in the preclerkship curriculum, the mechanisms to ensure adherence to these policies are often less well defined. APPROACH: In 2019, the University of Cincinnati College of Medicine (UCCOM) established a scheduling workgroup, the Student Workload Advisory Group (SWAG), which evolved into a collaborative effort to monitor and manage workload. SWAG created a workload calculator that could be applied to all preclerkship courses to monitor workload hours among medical students during academic years 2021 to 2022 through 2024 to 2025. OUTCOMES: Within the first year of formal monitoring, there were 27 instances in which student workload exceeded that defined in the workload policy. SWAG identified explicit and hidden workload exceedances. Explicit workload exceedances included requirements that can be captured on a course calendar, whereas hidden workload exceedances emerged after implementation of an assignment audit self-report tool. Multiple revisions to the workload policy were incorporated to ensure scheduled activities reflected the time needed to complete the activities, which led to a reduction in workload policy exceedances. More success was seen with a proactive approach that facilitates collaboration between SWAG and course directors to anticipate and address potential workload concerns before they occur. NEXT STEPS: The creation of a formal body consisting of faculty, staff, and students to monitor workload combined with a proactive monitoring plan to enforce workload policies represents a reproducible framework for other institutions seeking to create and/or enforce workload policies. The next step at UCCOM is to incorporate formal workload monitoring into clinical phases of the curriculum to monitor workload hours outside enforced duty hours to improve student wellness.