Prospective evaluation of patient recognition of emergency clinician roles and an intervention to improve recognition

Clinician misidentification is a significant issue in the Emergency Department (ED), and improving patients' understanding of care team roles is critical for clear communication and effective patient care. We aimed to measure clinician role misidentification rates in the ED and test if an educational intervention could improve patient identification, while exploring associations with patient and clinician characteristics.

This prospective controlled trial included 145 ED patients (70 control, 75 intervention). The intervention group received an educational sheet presenting clinician headshots with role descriptions. Participants were asked to identify one of their providers. Patient and clinician characteristics were recorded. The primary outcome was accuracy of clinician role identification. Secondary outcomes included changes after the intervention and associations with characteristics. Multivariable logistic regression was performed adjusting for patient age, gender, education level, and provider mask use.

A total of 145 encounters were analyzed (67 attending, 39 resident, 39 advanced practice providers). At baseline, 28 of 70 patients (40.0%) correctly identified clinician roles. The intervention improved correct identification to 48 of 75 patients (64.0%) compared to 40.0% in controls (p = 0.005). On multivariable analysis, the intervention remained independently associated with higher odds of correct identification (aOR 6.00, 95% CI 2.31-16.80; p < 0.001). Improved identification was associated with patient age, race, and education level, along with clinician age, role, and mask use.

Misidentification of ED clinician roles is influenced by patient and clinician characteristics. Our intervention significantly improved role identification and may help reduce misidentification in the ED.