Residents at Trauma Centers: Helping or Hurting?

Residency training allows medical graduates to obtain the skills necessary to become safe and effective physicians. Analyzing data from two periods, before residents (BRs) and during residents (DRs), at our institution allowed us to examine the association between resident involvement and patient outcomes. We hypothesized that including residents in trauma resuscitation activities would not be associated with increased detrimental patient outcomes.

We conducted a single-center retrospective review (January 1, 2018, to December 31, 2020) of patients that arrived as a Code T or trauma alert. Variables were compared for patients BR and DR to evaluate the association between trauma resident participation and trauma care efficiency and outcomes.

A total of 4204 patients met inclusion criteria; 2022 (48.1%) BR and 2182 (51.9%) DR. There was a significantly longer emergency department length of stay (182 min BR versus 192 min DR, P = 0.029) and time from the patient receiving a computed tomography scan to either admission or transport to the operating room DR (152 min BR versus 165 min DR, P = 0.030). There was a decrease in the time spent in the trauma bay DR (11 min DR versus 12 min BR, P < 0.001). There were significantly fewer pulmonary emboli during hospitalization DR (0.54% BR versus 0.14% DR), as well as fewer unexpected intensive care unit admissions following resident participation DR (2.18% BR versus 1.10% DR, P = 0.006. Mortality was not associated with resident participation (P = 0.184).

Resident participation in our trauma resuscitation efforts is associated with improved patient-centered outcomes with no increase in mortality. Except for differences in intensive care unit admissions and pulmonary emboli, there were few clinically significant differences between the BR era and DR era indicating that the incorporation of resident involvement is not detrimental to patient care.