Physician-Led Teams: A Model Curriculum for Emergency Medicine Residency

Physician-led teams in emergency medicine (EM) are associated with higher quality and value than independent non-physician practice, yet most residents receive little formal preparation in leading inter-professional teams that include nurse practitioners (NPs) and physician assistants (PAs). Clear, scalable training guidance for residency programs is lacking.

We conducted a narrative synthesis of national policy positions, scope-of-practice trends, and published literature on team leadership training in EM and related disciplines, including other specialties, nursing, and business/healthcare administration. Drawing on these sources and program leadership experience, we used a consensus-building process to define goals, core content, and instructional methods for a residency curriculum focused on physician-led inter-professional teams.

We identified persistent training gaps in role clarity, supervision, communication, and systems navigation. The proposed competency-based curriculum aligns with ACGME core competencies and EM Milestones (with emphasis on ICS2, PC1, and SBP2) and specifies: (1) foundational knowledge of team roles, supervision, and state/regulatory context; (2) leadership and communication skills, including feedback, conflict management, and shared decision-making; (3) clinical integration through structured bedside supervision of NPs/PAs; (4) quality, safety, documentation/billing, and medicolegal considerations; and (5) longitudinal assessment using direct observation, simulation checklists, multisource feedback (including NPs/PAs), and milestone-anchored entrustment decisions. Delivery modes include didactics, simulation, mentored clinical "pre-attending" experiences, and asynchronous resources, adaptable to local practice models.

EM residency programs can address a critical training gap by adopting a structured, longitudinal curriculum that prepares residents to lead inter-professional, physician-led teams. The curriculum presented offers standardized objectives and assessment strategies while allowing local customization, supporting safer supervision, clearer role alignment, and more reliable team performance after graduation.