title: Attending supervision of nonemergency medicine residents in a university hospital ED.
abstract: There have been a limited number of studies assessing the impact of attending physician supervision of residents in the emergency department (ED). The objective of this study is to describe the changes in patient care when attending emergency physicians (AEPs) supervise nonemergency medicine residents in a university hospital ED. This was a prospective study including 1,000 patients, 32 second- and third-year nonemergency medicine residents and eight AEPs. The AEPs classified changes in care for each case as major, minor, or none, according to a 40-item data sheet list. There were 153 major changes and 353 minor changes by the AEP. The most common major changes were ordering laboratory or x-ray tests that showed a clinically significant abnormality, and eliciting important physical exam findings. Potentially limb- or life-threatening errors were averted by the AEP in 17 patients. Supervision of nonemergency medicine residents in the ED resulted in frequent and clinically important changes in patient care.
authors.affiliation: Center for Emergency Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Holliman
authors.forename: R C
authors.initials: RC
authors.lastname: Wuerz
authors.forename: M J
authors.initials: MJ
authors.lastname: Kimak
authors.forename: K K
authors.initials: KK
authors.lastname: Burkhart
authors.forename: J W
authors.initials: JW
authors.lastname: Donovan
authors.forename: H L
authors.initials: HL
authors.lastname: Rudnick
authors.forename: M A
authors.initials: MA
authors.lastname: Bates
authors.forename: H A
authors.initials: HA
authors.lastname: Muller
mesh_terms: D003951:Diagnostic Errors; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards*; D010414:Pennsylvania; D011446:Prospective Studies; D011787:Quality of Health Care