BACKGROUND: According to the Accreditation Council for Graduate Medical Education emergency medicine (EM) program requirements, EM residents on EM rotations must be supervised by board-certified/board-prepared EM or pediatric EM (PEM) faculty. OBJECTIVE: We sought to understand the effect of allowing EM residents to be supervised by attending pediatricians while caring for pediatric urgent care patients. METHODS: The EM residents were permitted to staff pediatric urgent care patients with either an EM/PEM attending or an attending pediatrician from August 2017 to July 2018. Outcomes were assessed through resident focus groups, a mixed-methods survey of EM residents and EM/PEM/pediatrician attendings, and clinical outcomes, including length of stay, best evidence/clinical care guideline adherence, and 48-hour return visits requiring admission. Qualitative data were inductively coded using a phenomenological framework, with themes emerging from consensus discussion. RESULTS: Ninety percent of residents participated in 1 of 7 focus groups. Four key themes emerged from qualitative analysis of focus group transcripts: (1) pediatricians have unique skills that complement those of EM physicians; (2) EM resident education improved; (3) patients may get better care with dual staffing; and (4) other PEM department and urgent care team members may have benefited from the change. The survey response rate was 72%, and it did not uncover additional themes. Length of stay was shorter for patients supervised by attending pediatricians (114 versus 128 minutes, P < .001); there was no difference in best evidence/clinical care guideline adherence or 48-hour return visits requiring admission. CONCLUSIONS: Physicians' perceived education was improved by adding complementary perspectives without significant negative consequences for learners or patients. Accreditation Council for Graduate Medical Education 2020.
BACKGROUND: According to the Accreditation Council for Graduate Medical Education emergency medicine (EM) program requirements, EM residents on EM rotations must be supervised by board-certified/board-prepared EM or pediatric EM (PEM) faculty. OBJECTIVE: We sought to understand the effect of allowing EM residents to be supervised by attending pediatricians while caring for pediatric urgent care patients. METHODS: The EM residents were permitted to staff pediatric urgent care patients with either an EM/PEM attending or an attending pediatrician from August 2017 to July 2018. Outcomes were assessed through resident focus groups, a mixed-methods survey of EM residents and EM/PEM/pediatrician attendings, and clinical outcomes, including length of stay, best evidence/clinical care guideline adherence, and 48-hour return visits requiring admission. Qualitative data were inductively coded using a phenomenological framework, with themes emerging from consensus discussion. RESULTS: Ninety percent of residents participated in 1 of 7 focus groups. Four key themes emerged from qualitative analysis of focus group transcripts: (1) pediatricians have unique skills that complement those of EM physicians; (2) EM resident education improved; (3) patients may get better care with dual staffing; and (4) other PEM department and urgent care team members may have benefited from the change. The survey response rate was 72%, and it did not uncover additional themes. Length of stay was shorter for patients supervised by attending pediatricians (114 versus 128 minutes, P < .001); there was no difference in best evidence/clinical care guideline adherence or 48-hour return visits requiring admission. CONCLUSIONS: Physicians' perceived education was improved by adding complementary perspectives without significant negative consequences for learners or patients. Accreditation Council for Graduate Medical Education 2020.
Authors: Jin K Kim; Michael Chua; Luis Braga; Jacob C Langer; B J Hancock; Armando J Lorenzo; Darius Bagli; Walid A Farhat; Martin A Koyle Journal: J Pediatr Surg Date: 2018-10-29 Impact factor: 2.545
Authors: L M Arkin; K Buhr; H Brandling-Bennett; Y Chiu; B Chong; M Curran; R Hunt; A S Paller; V P Werth; M Klein-Gitelman; E von Scheven; K Ardalan Journal: Br J Dermatol Date: 2019-06-23 Impact factor: 9.302
Authors: Shawn L Ralston; Allan S Lieberthal; H Cody Meissner; Brian K Alverson; Jill E Baley; Anne M Gadomski; David W Johnson; Michael J Light; Nizar F Maraqa; Eneida A Mendonca; Kieran J Phelan; Joseph J Zorc; Danette Stanko-Lopp; Mark A Brown; Ian Nathanson; Elizabeth Rosenblum; Stephen Sayles; Sinsi Hernandez-Cancio Journal: Pediatrics Date: 2014-11 Impact factor: 7.124
Authors: Nathan Kuppermann; James F Holmes; Peter S Dayan; John D Hoyle; Shireen M Atabaki; Richard Holubkov; Frances M Nadel; David Monroe; Rachel M Stanley; Dominic A Borgialli; Mohamed K Badawy; Jeff E Schunk; Kimberly S Quayle; Prashant Mahajan; Richard Lichenstein; Kathleen A Lillis; Michael G Tunik; Elizabeth S Jacobs; James M Callahan; Marc H Gorelick; Todd F Glass; Lois K Lee; Michael C Bachman; Arthur Cooper; Elizabeth C Powell; Michael J Gerardi; Kraig A Melville; J Paul Muizelaar; David H Wisner; Sally Jo Zuspan; J Michael Dean; Sandra L Wootton-Gorges Journal: Lancet Date: 2009-09-14 Impact factor: 79.321
Authors: Allison Gates; Michelle Gates; Ben Vandermeer; Cydney Johnson; Lisa Hartling; David W Johnson; Terry P Klassen Journal: Cochrane Database Syst Rev Date: 2018-08-22