Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center.

Christine Babcock,Alyssa Bryant,James Ahn,Andrew Golden

doi:10.5811/westjem.2015.12.28977

Christine Babcock, Alyssa Bryant + Show 2 more

Open Access

https://doi.org/10.5811/westjem.2015.12.28977

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Abstract

IntroductionIn the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR.MethodsTRs were present in the ED from 12pm–10pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief “chalk talks,” instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care.ResultsSurvey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance.ConclusionThe presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

Highlights

In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge
The majority agreed that the teaching residents (TRs) improved patient care
Faculty agreed that the TR increased resident and medical students (MS) learning, as well as improved patient care and procedure performance

Summary

Introduction

In academic emergency departments (ED), formalizing the process to ensure high-quality clinical education for residents and medical students (MS) while maintaining quality healthcare delivery is difficult. Achieving this balance has been increasingly challenging with ED crowding and a decline in bedside teaching practices. ED crowding compounds this challenge; studies have shown mixed results on the effect increasing patient volumes have on MS and resident teaching.[4,5,6,7,8,9] To combat this issue, a number of institutions have implemented teaching attending physicians.[10,11] Students and residents generally perceived a Volume XVII, no. ED crowding compounds this challenge; studies have shown mixed results on the effect increasing patient volumes have on MS and resident teaching.[4,5,6,7,8,9] To combat this issue, a number of institutions have implemented teaching attending physicians.[10,11] Students and residents generally perceived a Volume XVII, no. 2 : March 2016

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