Department of Emergency Medicine, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, IL, USA.
Acad Emerg Med. 2011 Oct;18 Suppl 2:S59-64. doi: 10.1111/j.1553-2712.2011.01116.x.
Emergency medicine (EM) residency programs are increasingly asked to have measurable outcomes of residents' performance. Successful completion of the written and oral American Board of Emergency Medicine (ABEM) examinations is one key outcome. In the clinical practice of EM, emergency physicians (EPs) are often measured by their clinical productivity (patients per hour). This study explored the correlation between these measures of academic and clinical performance and hypothesized that clinical productivity would have a positive association with ABEM performance.
A prospective written survey was sent to all EPs completing training at an established Midwest 3-year EM residency program between 1994 and 2005 (53,000 annual visits in 1994 to 65,000 annual visits in 2005). Physicians self-reported their national ABEM written and oral board scores in a blinded fashion. Simulated oral board scores and senior written in-training examination scores were also recorded. Postgraduate Year 3 (PGY3) clinical productivity was calculated as annual patient encounters divided by hours worked. Correlations among these variables were assessed by Pearson's correlation coefficient, with p < 0.05 being considered statistically significant. Multiple regression analysis was performed for ABEM oral and written examination scores.
Fifty-six of 85 residents responded to the initial survey. There was no significant correlation between clinical productivity and ABEM scores, either written (r = -0.021, p = 0.881) or oral (r = -0.02, p = 0.879). There was also no significant correlation between productivity and simulated oral board scores (r = 0.065, p = 0.639) of PGY3 in-training scores (r = 0.078, p = 0.57). As previously reported, there were positive and significant correlations between PGY3 in-service scores and ABEM written examination scores (r = 0.60, p < 0.0001), as well as ABEM oral and written examination scores (r = 0.51, p < 0.0001). Multiple regression analysis revealed only the PGY3 in-training examination was a significant predictor of the ABEM oral and written scores (p < 0.001).
PGY3 resident clinical productivity, when measured as patients per hour, correlated poorly with academic performance when measured by written and oral ABEM scores. The PGY3 in-training examination was predictive of the ABEM written and oral examination scores.
急诊医学（EM）住院医师培训计划越来越多地要求对住院医师的表现进行可衡量的评估。成功完成美国急诊医师委员会（ABEM）的笔试和口试是一个关键的评估结果。在急诊医学的临床实践中，急诊医师（EP）的临床生产力（每小时看诊患者数）通常是他们的衡量标准。本研究探讨了这些学术和临床绩效衡量指标之间的相关性，并假设临床生产力与 ABEM 绩效呈正相关。
我们向 1994 年至 2005 年间在中西部地区一个为期 3 年的急诊医学住院医师培训计划中完成培训的所有 EP 发送了一份前瞻性书面调查（1994 年每年有 53000 次就诊，2005 年每年有 65000 次就诊）。医生以盲法方式报告他们在全国 ABEM 笔试和口试中的成绩。还记录了模拟口试和住院医师第三年书面中期考试成绩。将住院医师第三年的临床生产力计算为每年患者就诊次数除以工作小时数。使用 Pearson 相关系数评估这些变量之间的相关性，p<0.05 被认为具有统计学意义。对 ABEM 口试和笔试成绩进行多元回归分析。
共有 85 名住院医师中的 56 名对初始调查做出了回应。临床生产力与 ABEM 成绩之间没有显著相关性，无论是笔试（r=-0.021，p=0.881）还是口试（r=-0.02，p=0.879）。生产力与住院医师第三年培训模拟口试成绩（r=0.065，p=0.639）或住院医师第三年中期考试成绩（r=0.078，p=0.57）之间也没有显著相关性。正如之前报道的，住院医师第三年在职考试成绩与 ABEM 笔试成绩（r=0.60，p<0.0001）以及 ABEM 笔试和口试成绩（r=0.51，p<0.0001）之间呈正相关且具有统计学意义。多元回归分析显示，只有住院医师第三年培训考试是 ABEM 口试和笔试成绩的显著预测因素（p<0.001）。
以每小时看诊患者数衡量的住院医师第三年临床生产力与 ABEM 笔试和口试成绩等学术表现相关性较差。住院医师第三年培训考试可预测 ABEM 笔试和口试成绩。
