Comparison of the Standardized Video Interview and Interview Assessments of Professionalism and Interpersonal Communication Skills in Emergency Medicine

摘要

Background: In March 2018, the Centers for Medicareand Medicaid Services (CMS) announced that medical studentdocumentation of patient care services would be acceptedfor billing purposes. Starting in August 2018, all fourthyearmedical students enrolled in the four-week emergencymedicine (EM) rotation at our academic emergencydepartment (ED) undergo two hours of documentation trainingas part of orientation and then assume sole responsibility fordocumentation of all patients under their care. Faculty reviseand co-sign these notes according to institutional policy.Given the recency of the change in CMS policy, it is unknownhow implementing medical student documentation affects thelearner and educator experiences.Objectives: We sought to characterize EM facultyperception of medical student responsibility for documentationin an academic ED. We hypothesized that faculty may findthe need to heavily revise student notes to not be worth theassistance given in writing them, and that this may result inless face-to-face education between students and faculty.Methods: To assess educator experience, a web-basedsurvey was created and distributed by e-mail to all EM facultywithin our department starting October 2018. Responsechoices were modeled after validated Likert-type scaleresponse anchors. All responses were recorded anonymously.Results: We received 29 faculty responses (81% responserate) to the survey. Their responses were as follows: 79%of faculty members perceived medical student notes to be“always” or “usually” useful for clinical documentation; 86%felt that student notes “always,” “usually,” or “frequently”contained enough information for billing and coding; 93%“strongly agreed” or “agreed” that it is worth revising andco-signing student notes compared to faculty writing notesthemselves; and 69% of faculty noticed themselves havingmore face-to-face interaction with students on shift whenstudents wrote notes compared to when they didn’t. Nearly allfaculty (97%) found medical students to be a more useful partof the team when students write notes.Conclusion: Although limited to a single academicED, our results suggest that implementing medical studentdocumentation responsibility can result in high EM facultysatisfaction, increased face-to-face interaction between facultyand students, and a more prominent role for medical studentson the physician team.