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West J Emerg Med. 2013 Nov;14(6):585-9. doi: 10.5811/westjem.2012.12.12683.

The impact of working with medical students on resident productivity in the emergency department.

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St. Luke's University Hospital and Health Network, Bethlehem, Pennsylvania.



Academic emergency departments (ED) strive to balance educational needs of residents and medical students with service requirements that optimize patient care. No study to date has evaluated whether resident precepting of medical students affects residents' clinical productivity. Understanding the interplay of these variables may allow for ED staffing that maximizes productivity. We sought to determine whether the precepting of medical students impacts resident productivity.


This study was performed at a tertiary care ED with a 70,000 annual patient census. We performed a computer-based (Verinet Systems, Alachua, Fl) retrospective review of patient encounters initiated by second- and third-year emergency medicine residents (PGY2 and PGY3) assigned to medical student precepting shifts and compared these shifts with those of the same residents when not working with students. Data collection over 12 months included shift length from the monthly schedule and number of patients and relative value units (RVUs) from the Verinet System. Patients seen per hour (pt/hr) and relative value unit per hour (RVUs/hr) were calculated. We compared parameters using two-tailed t-tests. The hospital's institutional review board approved this study.


Daily census was 202 on days without medical student rotators and 200 on days with student rotators (p=0.29). While precepting students, PGY3s saw 1.40 pt/hr versus 1.39 pt/hr without students (p=0.88) and PGY2s saw 1.28 pt/hr with students compared to 1.28 pt/hr without students (p=0.94). PGY3s generated 3.97 RVU/hr with students and 4.03 RVU/hr while working independently (p=0.68) and PGY2s generated 3.82 RVU/hr working with students versus 3.74 RVU/hr without (p=0.44). There were no productivity differences between resident precepting shifts and regular shifts.


In this study, resident productivity was not affected by precepting medical students.

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