The Cost of a Learner in the Pediatric Emergency Department: A Comparison Across Two Pediatric Emergency Departments

摘要

Experimental learning is a foundation of medical education, but a learner in the pediatric emergency department impacts utilization, time and disposition metrics. Our study sought to compare the effect of a resident learner on metrics between 2 pediatric emergency departments. This retrospective study was conducted in 2019 in 2 pediatric emergency departments of tertiary care hospitals. We compared various time, utilization, and disposition metrics between resident-covered and nonresident-covered patients. A total of 62,548 patient encounters were included in our analysis, with 8102 (13%) encounters were resident-managed. Residents were consistently found to see higher-acuity patients, which led to increased relative value unit generation. Residents used more diagnostic testing consistently across both sites. However, we found significant differences between time and disposition metrics between the 2 sites. Residents see sicker patients and tend to order more ancillary tests, which ultimately leads to increased relative value unit generation. We hypothesize that the difference in metrics seen could be explained by the training background of residents, as well as efficiencies of the department as a whole.