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The effect of ED crowding on education
Jesse M Pines1, Anjeli Prabhu, Christine M McCusker
1Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. pinesjes@uphs.upenn.edu
The American Journal of Emergency Medicine
|February 18, 2010
Summary
Emergency department crowding does not impact the quality of resident and medical student education during patient encounters. This study found no significant correlation between crowding metrics and educational assessment scores.
Area of Science:
- Medical Education
- Emergency Medicine
- Healthcare Management
Background:
- Emergency department (ED) crowding is a prevalent issue in healthcare systems.
- Concerns exist regarding its potential negative impact on the quality of medical education.
- Understanding this relationship is crucial for optimizing training environments.
Purpose of the Study:
- To investigate the association between emergency department crowding and the quality of resident and medical student education.
- To assess if crowding affects faculty-learner interactions during individual patient encounters.
Main Methods:
- A cross-sectional study was conducted in an academic ED over 5 weeks.
- Surveys assessed attending physician performance in teaching, clinical care, approachability, and helpfulness.
- Crowding measures (waiting room volume, occupancy, admitted patients, patient-hours) were correlated with educational scores.
Main Results:
- 352 faculty-learner encounters were analyzed, with a median educational score of 16/20.
- No significant correlation was found between ED crowding levels and overall educational scores or individual assessment domains.
- Adjusted analyses confirmed no association between ED crowding and the quality of teaching or other assessed domains.
Conclusions:
- Emergency department crowding does not appear to negatively affect the quality of medical education provided during individual patient encounters.
- These findings suggest that educational quality in the ED may be resilient to crowding pressures.
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