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West J Emerg Med. 2010 Dec;11(5):470-3.

Targeted Needs Assessment of Off-service Residents in Emergency Medicine.

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Jesse Brown VA Medical Center, Chicago, IL.



The purpose of this study is to evaluate the needs of internal medicine residents rotating through the emergency department (ED).


A survey was distributed to 100 internal medicine residents (post-graduate years 2 and 3) from two different residency programs before the start of their emergency medicine (EM) rotation. Residents ranked the level of importance and the level of preparedness for 23 different EM topics, using a Likert-type scale ranging from 1 (least important/least prepared) to 4 (most important/most prepared). We calculated delta values (Δ) from the difference between importance and preparedness and undertook significance testing of this difference.


A total of 71 out of 100 surveys were completed properly and returned. Internal medicine residents felt most ill-prepared in the areas of orthopedics, environmental emergencies, otolaryngology, airway management, and ophthalmology. The largest perceived gaps between importance and preparedness lay within the areas of airway management (Δ=1.30), ophthalmology (Δ=1.10), environmental emergencies (Δ=0.96), and orthopedics (Δ=0.96).


Our data suggest that internal medicine residents are inadequately prepared for EM topics that they feel are important to their education, specifically airway management, ophthalmology, environmental emergencies and orthopedics. It is quite possible that other specialty residents are also poorly prepared for similar core EM topics. These data will hopefully guide future curricular change for off-service residents in the ED.


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