Abstract

ABSTRACT Introduction: Evaluation of resident competencies became the expectation in residency programs beginning in 2007. The six general competency areas residents were expected to demonstrate prior to graduation, were presented as equivalent. This study’s purpose was to identify specific emergency physician behaviors that contribute to them being judged as exemplary by their peers. Data were collected from experienced emergency medicine physicians and fourth-year medical students applying for emergency medicine residency. The two cohorts allowed analyses of differences between those early, versus more advanced in their career paths. Methods: Subjects were instructed to bring to mind one or more outstanding emergency physician(s) and list all exemplary behaviors witnessed in an act-frequency questionnaire. They were also asked to identify specific negative behaviors notably absent from the exemplary physicians’ repertoire. The overall response rate among subjects invited to participate was 131/194 (71%). Results: After six independent judges sorted responses into the six general competencies, the following ranking emerged: Tied for first, Interpersonal and Communication Skills, and Professionalism; third, Practice-based Learning and Improvement; fourth, Patient Care; fifth, Medical Knowledge and sixth, Systems-based Practice. Seventy-one emergency medicine specific sub-competencies were also rank ordered to identify the top 10. Differences were found between those about to enter emergency medicine residency training and those with experience in the emergency medicine specialty. Conclusion: Training of exemplary emergency medicine physicians will require a stronger emphasis on Interpersonal and Communication Skills, and Professionalism which accounted for 75% of the total behaviors listed by both cohorts.

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