The Effect of Emergency Department Crowding on Education: Blessing or Curse?

Emergency department (ED) crowding is a national crisis that contributes to medical error and system inefficiencies. There is a natural concern that crowding may also adversely affect undergraduate and graduate emergency medicine (EM) education. ED crowding stems from a myriad of factors, and indivi...

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Published inAcademic emergency medicine Vol. 16; no. 1; pp. 76 - 82
Main Authors Shayne, Philip, Lin, Michelle, Ufberg, Jacob W., Ankel, Felix, Barringer, Kelly, Morgan‐Edwards, Sarah, DeIorio, Nicole, Asplin, Brent
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.01.2009
Wiley Subscription Services, Inc
Subjects
Biomedical Research
Clinical Competence
Crowding
education
Education, Medical, Graduate - standards
emergency department
Emergency medical care
emergency medicine
Emergency Medicine - education
Emergency Service, Hospital - organization & administration
Health education
Humans
Impact analysis
Internship and Residency - standards
Models, Educational
Quality Assurance, Health Care
United States
United States
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Summary:Emergency department (ED) crowding is a national crisis that contributes to medical error and system inefficiencies. There is a natural concern that crowding may also adversely affect undergraduate and graduate emergency medicine (EM) education. ED crowding stems from a myriad of factors, and individually these factors can present both challenges and opportunities for education. Review of the medical literature demonstrates a small body of evidence that education can flourish in difficult clinical environments where faculty have a high clinical load and to date does not support a direct deleterious effect of crowding on education. To provide a theoretical framework for discussing the impact of crowding on education, the authors present a conceptual model of the effect of ED crowding on education and review possible positive and negative effects on each of the six recognized Accreditation Council for Graduate Medical Education (ACGME) core competencies.
Bibliography:The Society for Academic Emergency Medicine (SAEM) Crowding Taskforce Education Workgroup consists of Louis Binder, MD, James Creel, MD, Susan Farrell, MD, Jonathan Fisher, MD, Sean Kelley, MD, and Peter Sokolove, MD.
Presented at the SAEM Academic Assembly in Washington, DC, May 31, 2008.
A related commentary appears on page 56.
This manuscript has been reviewed and approved by the SAEM Board of Directors, April 2008.
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ISSN:1069-6563
1553-2712
DOI:10.1111/j.1553-2712.2008.00261.x