Ou Evan, Mulcare Mary, Clark Sunday, Sharma Rahul
J Grad Med Educ. 2017 Aug;9(4):518-522. doi: 10.4300/JGME-D-16-00807.1.
Medical scribes have been shown to improve emergency department (ED) throughput, physician productivity metrics, and patient satisfaction by fulfilling primary documentation and nonclinical functions. Little research has been done to date to study the effect of implementing a scribe program in a residency setting.
Our goal was to investigate emergency medicine residents' perception of their educational experience, including interactions with faculty, before and after the implementation of an ED scribe program.
We used a pre-post design to assess residents' perceptions of their educational experience before and after implementation of the scribe program. Residents at a large, urban academic medical center with an Accreditation Council for Graduate Medical Education-accredited, 4-year emergency medicine residency program were surveyed during August 2015 (prior to the implementation of the scribe program) and April 2016 (6 months after implementation).
Residents reported improved educational experiences with statistically significant changes in the following areas: increased interaction with faculty due to fewer documentation requirements ( = .012); more face-to-face teaching with faculty ( < .001); increased faculty supervision for procedures ( = .016); and a decrease of delays in patient disposition due to incomplete documentation ( = .029).
Implementation of an ED scribe program in an urban 4-year emergency medicine residency program led to improvements in residents' perceptions of their education.
医疗抄写员已被证明可通过履行主要文档记录和非临床功能来提高急诊科(ED)的工作效率、医生的生产力指标以及患者满意度。迄今为止,关于在住院医师培训环境中实施抄写员计划的效果的研究很少。
我们的目标是调查急诊医学住院医师在实施急诊科抄写员计划之前和之后对其教育经历的看法,包括与教员的互动。
我们采用前后设计来评估住院医师在抄写员计划实施前后对其教育经历的看法。2015年8月(抄写员计划实施前)和2016年4月(实施6个月后)对一家大型城市学术医疗中心的住院医师进行了调查,该中心设有经研究生医学教育认证委员会认证的为期4年的急诊医学住院医师培训项目。
住院医师报告称教育经历有所改善,在以下方面有统计学意义的变化:由于文档记录要求减少,与教员的互动增加(P = 0.012);与教员的面对面教学增多(P < 0.001);教员对操作的监督增加(P = 0.016);以及因文档记录不完整导致的患者处置延迟减少(P = 0.029)。
在城市4年急诊医学住院医师培训项目中实施急诊科抄写员计划可改善住院医师对其教育的看法。