Outcome Feedback within Emergency Medicine Training Programs: An Opportunity to Apply the Theory of Deliberate Practice?

Author:

Dalseg Timothy R.,Calder Lisa A.,Lee Curtis,Walker Jaymie,Frank Jason R.

Abstract

AbstractObjectivesOutcome feedback is the process of learning patient outcomes after their care within the emergency department. We conducted a national survey of Canadian Royal College emergency medicine (EM) residents and program directors to determine the extent to which active outcome feedback and follow-up occurred. We also compared the perceived educational value of outcome feedback between residents and program directors.MethodsWe distributed surveys to all Royal College-accredited adult and pediatric EM training programs using a modified Dillman method. We analyzed the data using student’s t-test for continuous variables and Fisher’s exact test for categorical variables.ResultsWe received 210 completed surveys from 260 eligible residents (80.8%) and 21 of 24 program directors (87.5%) (overall 81.3%). Mandatory active outcome feedback was not present in any EM training program for admitted or discharged patients (0/21). Follow-up was performed electively by 89.4% of residents for patients admitted to the hospital, and by 44.2% of residents for patients discharged home. A majority of residents (76.9%) believed that patient follow-up should be mandatory compared to 42.9% of program directors (p=0.002). The perceived educational value of outcome feedback was 5.8/7 for residents and 5.1/7 for program directors (difference 0.7; p=0.002) based on a seven-point Likert scale (1=not important; 7=very important).ConclusionWhile Canadian EM training programs do not mandate follow-up, it is performed electively by the majority of residents surveyed. Residents place a significantly greater educational value on outcome feedback than their program directors, and believe that follow-up should be a mandatory component of EM residencies.

Publisher

Springer Science and Business Media LLC

Subject

Emergency Medicine

Reference20 articles.

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2. The Royal College of Physicians and Surgeons of Canada. Objectives of Training in Emergency Medicine. 2008. Reviewed 2011. Available at: http://rcpsc.medical.org/information/index.php?specialty=122&submit=Select (accessed June 11, 2013).

3. Postcare follow-up in emergency medicine residencies;Adams;Ann Emerg Med,1992

4. The American College of Graduate Medical Education and American Board of Emergency Medicine. The emergency medicine milestone project. 2012. Available at: https://www.abem.org/PUBLIC/portal/alias__Rainbow/lang__en-US/tabID__4341/DesktopDefault.aspx (accessed March 27, 2013).

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