Resident Supervision and Patient Care: A Comparative Time Study in a Community-Academic Versus a Community Emergency...

Area of Science:

• Emergency Medicine
• Medical Education
• Health Services Research

Background:

• Emergency departments (EDs) face increasing demands on attending physician (EP) time.
• The presence of emergency medicine (EM) residents may impact EP time allocation between direct and indirect patient care.
• Understanding time allocation is crucial for optimizing ED efficiency and physician workload.

Purpose of the Study:

• To compare the time attending emergency physicians (EPs) spend on direct and indirect patient care activities in EDs with and without EM residents.
• To quantify the time EPs dedicate to supervising residents in an academic ED setting.

Main Methods:

• An observational, time-motion study was conducted involving 25 EPs across two ED settings: a community-academic ED and a nonacademic community ED.
• Two observations per EP were performed, with data collected on time spent on various patient care activities.
• Descriptive statistics and Wilcoxon two-sample tests were used to analyze time differences.

Main Results:

• EPs in the community-academic ED spent 14.2% of their time (8.5 minutes/hour) supervising EM residents.
• Supervision time was offset by a reduction in indirect patient care activities, such as communication and electronic health record work.
• No statistically significant difference in direct patient care time or attending patient load was observed between the two ED types.

Conclusions:

• EPs supervising residents in academic EDs allocate a significant portion of their time to supervision.
• Supervision does not appear to compromise direct patient care time; instead, it is largely offset by efficiencies in indirect care.
• These findings suggest that integrating residents into EDs can be managed without negatively impacting direct patient care delivery.