An observational study of emergency department intern activities.
OBJECTIVE
To describe how intern time is spent, and the frequency of activities performed by interns during emergency department (ED) rotations.


METHODS
Prospective observational study of 42 ED interns from three Melbourne city teaching hospitals during 5 months in 2006. Direct observations were made by a single researcher for 390.8 hours, sampling all days of the week and all hours of the day.


METHODS
Proportion of time spent on tasks and number of procedures performed or observed by interns.


RESULTS
Direct patient-related tasks accounted for 86.6% of total intern time, including 43.9% spent on liaising and documentation, 17.5% obtaining patient histories, 9.3% on physical examinations, 5.6% on procedures, 4.8% ordering or interpreting investigations, 3.0% on handover and 4.9% on other clinical activities. Intern time spent on non-clinical activities included 4.2% on breaks, 3.7% on downtime, 1.7% on education, and 1.3% on teaching others. Adjusted for an 8-week term, the ED intern would take 253 patient histories, consult more senior ED staff on 683 occasions, perform 237 intravenous cannulations/phlebotomies, 39 arterial punctures, 12 wound repairs and apply 16 plasters. They would perform chest compressions under supervision on seven occasions, observe defibrillation twice and intubation once, but may not see a thoracostomy.


CONCLUSIONS
The ED exposes interns to a broad range of activities. With the anticipated increase in intern numbers, dilution of the emergency medicine experience may occur, and requirements for supervision may increase. Substitution of ED rotations may deprive interns of a valuable learning experience.
Zhu
Jia Ni
JN
Emergency Practice Innovation Centre, St. Vincent's Hospital, Melbourne, VIC.
Weiland
Tracey J
TJ
Taylor
David M
DM
Dent
Andrew W
AW
D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012494:Sampling Studies; D013996:Time and Motion Studies; D014739:Victoria; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data*