Hayley E Andre1, Michelle Daniel2, Mary R C Haas2. 1. Department of Emergency Medicine University of Michigan Emergency Medicine Residency Ann Arbor MI USA. 2. and the Department of Emergency Medicine University of Michigan Medical School Ann Arbor MI USA.
Abstract
BACKGROUND: The emergency department environment requires the clinician-educator to use adaptive teaching strategies to balance education with efficiency and patient care. Recently, alternative approaches to the traditional serial trainee-attending patient evaluation model have emerged in the literature. METHODS: The parallel encounter involves the attending physician and resident seeing the patient independently. Instead of the trainee delivering a traditional oral case presentation, the trainee does not present the history and examination to the attending physician. Rather, the attending and trainee come together following their independent evaluations to jointly discuss and formulate the assessment and plan. RESULTS: The parallel encounter has the potential to enhance the teaching encounter by emphasizing clinical reasoning, reduce cognitive bias by integrating two independent assessments of the same patient, increase attending workflow flexibility and efficiency, and improve patient satisfaction and outcomes by reducing time to initial provider contact. The attending must be mindful of protecting resident autonomy. This model tends to work better for more senior learners. CONCLUSIONS: The parallel encounter represents a novel approach to the traditional serial trainee-attending patient evaluation model that may enhance the teaching encounter and improve patient care.
BACKGROUND: The emergency department environment requires the clinician-educator to use adaptive teaching strategies to balance education with efficiency and patient care. Recently, alternative approaches to the traditional serial trainee-attending patient evaluation model have emerged in the literature. METHODS: The parallel encounter involves the attending physician and resident seeing the patient independently. Instead of the trainee delivering a traditional oral case presentation, the trainee does not present the history and examination to the attending physician. Rather, the attending and trainee come together following their independent evaluations to jointly discuss and formulate the assessment and plan. RESULTS: The parallel encounter has the potential to enhance the teaching encounter by emphasizing clinical reasoning, reduce cognitive bias by integrating two independent assessments of the same patient, increase attending workflow flexibility and efficiency, and improve patient satisfaction and outcomes by reducing time to initial provider contact. The attending must be mindful of protecting resident autonomy. This model tends to work better for more senior learners. CONCLUSIONS: The parallel encounter represents a novel approach to the traditional serial trainee-attending patient evaluation model that may enhance the teaching encounter and improve patient care.
Authors: Catherine James; Marvin Harper; Patrick Johnston; Brian Sanders; Michael Shannon Journal: Acad Emerg Med Date: 2009-08-10 Impact factor: 3.451