401 Worthy Investment: The Need for a Business and Administrative Curriculum for Emergency Medicine Residents

Abstract

Many believe that business principles related to the practice of EM should be taught during residency, and that many residency programs may not currently equip graduates with this essential knowledge. Until now, no national needs assessment survey has been performed to test these hypotheses, or to assess the current learning environment and identify the needs and preferences of learners and other stakeholders as recommended by Kern’s model of curriculum development. A prospective, online, cross sectional needs assessment was distributed to EM residents (via unique links to EMRA members) and attendings (via invitations shared on 40 departmental listservs, ACEP engagED, CORD, and 3 ACEP chapters). 253 attendings (81.3% academic faculty) and 207 PGY1-4 residents from 191 programs responded. 89.3% of overall respondents indicated that learning about business and administrative topics during EM residency is important or very important (no difference between residents and attendings, p=0.78). 51.4% of residents rated their knowledge of these topics as below average. Overall, 61% of residents stated their residency program does not prepare graduates for EM administrative challenges, though residents at programs with administrative electives feel more prepared than those at programs without electives, 47.2% vs 18.6% respectively (p<0.01). “Lack of time” was the top barrier identified by both residents and attendings, 57.8% and 39.7% respectively. The second largest barrier identified by attendings was “lack of faculty expertise” (32.9%); however, residents were significantly less likely to cite this as a barrier (10.2%, p<0.01). The most preferred learning method for residents was “self-paced online learning” (24.8%), followed by ”administrative case discussions” (17.0%). Learning business and administrative topics is regarded as very important during residency, yet the majority of residents report low levels of knowledge and preparation even if their program offers an administrative elective, and many faculty do not feel like they have content expertise. Based upon this targeted needs assessment, there is an opportunity to create a national, self-paced, online, case-based curriculum.