EducationQuantification of Procedures and Resuscitations in an Emergency Medicine Residency☆
Introduction
One component of optimal training in emergency medical procedures is the performance of a sufficient number to promote competence, but there are no data that govern how many are necessary 1, 2. An accurate catalogue of this experience is necessary for several reasons. First, for individual residents, paucity of experience may translate into inadequate skill, and documented experience during training supports credentialling for independent practice. Programmatically, because the Emergency Medicine Residency Review Committee (RRC-EM) requires each program to report the average number of procedures and resuscitations performed by its residents, such a catalog is mandatory [2]. Variability in skill and motivation between residents and between programs at different sites (urban vs. rural) and of different lengths should result in wide differences in procedural and resuscitation experience. Only one previous report [1]detailed these activities for a single class of residents in Texas. We report a larger sample across four residency classes, expanding on a preliminary report [3].
Section snippets
Materials and Methods
This study was conducted at the University of California, Irvine (UCI), Emergency Medicine Residency, in Orange, CA. Training in this emergency medicine resident year 1 (EM-1) through emergency medicine resident year 3 (EM-3) residency takes place predominantly at UCI Medical Center, an urban, 400-bed, Level I Trauma Center with an annual emergency department (ED) census of 36,000 patients, and an annual major trauma census of 1,800. The department admits 27% of its patients, with half of these
Results
Procedure and resuscitation experience for 24 EM residents are shown in Table 1. The 2-month audit of compliance in the ED shows that approximately 60% of the actual procedures performed were recorded in the system (Table 1). We did not find any procedures recorded on data sheets that were not present on the patient charts.
For 3 years, when there were 18 residents, recorded procedures by academic year were as follows: 1993–1994 (2561), 1994–1995 (1781), and 1995–1996 (2350). Procedures recorded
Discussion
The use of computerized databases for tracking EM resident experience has several advantages. The ease of data retrieval from a centralized database provides for a quick, ongoing analysis of resident performance in which weaknesses and deficiencies can be pinpointed and improved. Procedure experience has become a part of resident evaluation sessions. Residents and faculty subsequently pay special attention during clinical rotations to areas of inexperience, and supplement these under close
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Education is coordinated by Stephen R. Hayden, md, of the University of California San Diego Medical Center, San Diego, California