Medical student procedures and attending faculty exposure

The aim of this study was to determine whether medical students working with the same attending on multiple shifts as opposed to a variety of attendings leads to the performance of more procedures during their emergency medicine (EM) elective.

This was a retrospective observational study conducted in an Emergency Department with a census of 150,000 patients per year and a 3 year EM residency. Fourth-year medical student Attendance/Procedure Logs from July 2004 to March 2007 were reviewed. Students were divided into two groups: those who worked four or more shifts with a single attending (study group) and those who worked less than four shifts with any single attending (control group). The number of procedures performed in each group was compared.

Of 144 medical students, 63 (43.8%) were in the study group and 81 (56.2%) were in the control group. During the study dates, medical students recorded a total of 1327 procedures. Mean number of procedures performed in the study group (12.9, 95% CI 11.7 to 14.0) was higher than in the control group (6.3, 95% CI 5.4 to 7.2). This pattern remained true in every recorded category: arterial blood gas, abscess drainage, laceration repair, lumbar puncture and nasogastric tube.

Medical students that worked four or more shifts with a single EM attending performed twice as many overall procedures (12.9 vs 6.3) and significantly more invasive procedures than medical students who worked with a variety of attendings during their 4th-year EM elective.