Abstract
There is a paucity of research on the quality and quantity of clinical teaching in the emergency department (ED) setting. While many factors impact residents’ perceptions of attending physicians’ educational skill, the authors hypothesized that the amount of time residents spend with attending in direct teaching is a determinant of residents’ perception of their shift’s educational value. Researchers shadowed emergency medicine (EM) attendings during ED shifts, and recorded teaching time with each resident. Residents were surveyed on their assessment of the educational value (EV) of the shift and potential confounders, as well as the attending physician’s teaching quality using the ER Scale. The study was performed in the EDs of two urban teaching hospitals affiliated with an EM residency program. Subjects were EM residents and rotators from other specialties. The main outcome measure was the regression of impact of teaching time on EV. Researchers observed 20 attendings supervising 47 residents (mean 2.35 residents per attending, range 2–3). The correlation between teaching time in minutes (mean 60.8, st.dev 25.6, range 7.6–128.1) and EV (mean 3.45 out of 5, st. dev 0.75, range 2–5) was significant (r = 0.302, r 2 = 0.091, p < 0.05). No confounders had a significant effect. The study shows a moderate correlation between the total time attendings spend directly teaching residents and the residents’ perception of educational value over a single ED shift. The authors suggest that mechanisms to increase the time attending physicians spend teaching during clinical shifts may result in improved resident education.
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Steiner IP, Yoon PW, Kelly KD, Diner BM, Donoff MG, Mackey DS, Rowe BH (2003) Resident evaluation of clinical teachers based on teachers’ certification. Acad Emerg Med 10(7):731–737
Thurgur L, Bandiera G, Lee S, Tiberius R (2005) What do emergency medicine learners want from their teachers? A multicenter focus group analysis. Acad Emerg Med 12(9):856–861
Fluit CR, Bolhuis S, Grol R, Laan R, Wensing M (2010) Assessing the quality of clinical teachers. J Gen Intern Med 25(12):1337–1345
Steiner IP, Franc-Law J, Kelly KD, Rowe BH (2000) Faculty evaluation by residents in an emergency medicine program: A new evaluation instrument. Acad Emerg Med 7(9):1015–1021
Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40:879–891
DeBehnke DJ (2001) Clinical supervision in the emergency department: a costly inefficiency for academic medical centers. Acad Emerg Med 8(8):827–828
Atzema C, Bandiera G, Schull M (2005) Emergency department crowding: the effect on resident education. Ann Emerg Med 45:276–281
Berger TJ, Ander DS, Metrecia LT, Berle DC (2004) The impact of the demand for clinical productivity on student teaching in academic emergency departments. Acad Emerg Med 11(12):1364–1367
Begaz T, Decker C, Treat R, Tews M (2011) No relationship between measures of clinical efficiency and teaching effectiveness for emergency medicine faculty. Emerg Med J 28:37–39
Hemphill RR, Heavrin BS, Lesnick J, Santen SA (2011) Those who can, do and they teach too: faculty clinical productivity and teaching. West J Emerg Med 12(2):254–257
Kelly S, Shapiro N, Woodruff M, Corrigan K, Sanchez L, Wolfe R (2007) The effects of clinical workload on teaching in the emergency department. Acad Emerg Med 14(6):526–531
Mahler SA, McCartney JR, Swoboda TK, Yorek L, Arnold TC (2012) The impact of emergency department overcrowding on resident education. J Emerg Med 42(1):69–73
Pines JM, Prabhu A, McCusker CM, Hollander JE (2010) The effect of ED crowding on education. Am J Emerg Med 28:217–220
Mourad O, Redelmeier DA (2006) Clinical teaching and clinical outcomes: teaching capability and its association with patient outcomes. Med Ed 40:637–644
Nisbett RE, Wilson TD (1977) The halo effect: evidence for unconscious alteration of judgments. J Personality Social Psychology 35(4):250–256
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Dr. Trueger receives a stipend for his work as Social Media Editor for Emergency Physicians Monthly.
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This study was approved by the local institutional committee for human research.
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Hexom, B., Trueger, N., Levene, R. et al. The educational value of emergency department teaching: it is about time. Intern Emerg Med 12, 207–212 (2017). https://doi.org/10.1007/s11739-016-1447-1
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DOI: https://doi.org/10.1007/s11739-016-1447-1