000			04133nam a22004457a 4500
008			160113s20142014 xxu||||| |||| 00| 0 eng d
022			_a1936-900X
040			_aOvid MEDLINE(R)
099			_a24578767
245			_aImpact of learners on emergency medicine attending physician productivity.
251			_aThe Western Journal of Emergency Medicine. 15(1):41-4, 2014 Feb.
252			_aWest J Emerg Med. 15(1):41-4, 2014 Feb.
253			_aThe western journal of emergency medicine
260			_c2014
260			_fFY2014
266			_d2016-01-13
520			_aCONCLUSION: EM attending physicians paired with a resident in a one-on-one teaching model saw statistically significantly more patients per hour (0.12 more patients per hour) than EM attending physicians alone. EM attending physicians paired with a medical student saw the same number of patients per hour compared with working alone.
520			_aINTRODUCTION: Several prior studies have examined the impact of learners (medical students or residents) on overall emergency department (ED) flow as well as the impact of resident training level on the number of patients seen by residents per hour. No study to date has specifically examined the impact of learners on emergency medicine (EM) attending physician productivity, with regards to patients per hour (PPH). We sought to evaluate whether learners increase, decrease, or have no effect on the productivity of EM attending physicians in a teaching program with one student or resident per attending.
520			_aMETHODS: This was a retrospective database review of an urban, academic tertiary care center with 3 separate teams on the acute care side of the ED. Each team was staffed with one attending physician paired with either one resident, one medical student or with no learners. All shifts from July 1, 2008 to June 30, 2010 were reviewed using an electronic database. We predefined a shift as "Resident" if > 5 patients were seen by a resident, "Medical Student" if any patients were seen by a medical student, and "No Learners" if no patients were seen by a medical student or resident. Shifts were removed from analysis if more than one learner saw patients during the shift. We further stratified resident shifts by EM training level or off-service rotator. For each type of shift, the total number of patients seen by the attending physician was then divided by 8 hours (shift duration) to arrive at number of patients per hour.
520			_aRESULTS: We analyzed a total of 7,360 shifts with 2,778 removed due to multiple learners on a team. For the 2,199 shifts with attending physicians with no learners, the average number of PPH was 1.87(95% confidence interval [CI] 1.86,1.89). For the 514 medical student shifts, the average PPH was 1.87(95% CI 1.84,1.90), p = 0.99 compared with attending with no learner. For the 1,935 resident shifts, the average PPH was 1.99(95% CI 1.97,2.00). Compared with attending physician with no learner, attending physicians with a resident saw more PPH (1.99 vs 1.87, p<0.005). There was no statistically significant difference found between EM1: 1.98PPH, EM2: 1.99PPH, EM3: 1.99PPH, and off-service rotators: 1.99PPH.
546			_aEnglish
650			_a*Efficiency, Organizational
650			_a*Emergency Medicine/ed [Education]
650			_a*Emergency Service, Hospital/sn [Statistics & Numerical Data]
650			_aAcademic Medical Centers/sn [Statistics & Numerical Data]
650			_aHumans
650			_aInternship and Residency/sn [Statistics & Numerical Data]
650			_aRetrospective Studies
650			_aStudents, Medical/sn [Statistics & Numerical Data]
650			_aTertiary Care Centers/sn [Statistics & Numerical Data]
651			_aMedStar Washington Hospital Center
656			_aEmergency Medicine
657			_aJournal Article
700			_aDubin, Jeffrey
700			_aMaloy, Kevin
700			_aWilson, Matthew D
790			_aBhat R, Dubin J, Maloy K
856			_uhttp://dx.doi.org/10.5811/westjem.2013.7.15882 _zhttp://dx.doi.org/10.5811/westjem.2013.7.15882
942			_cART _dArticle
999			_c1607 _d1607