Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Medical students transition to intern year with significant variability in prior clinical experience depending on their medical school education. This leads to notable differences in the interns’ ability to perform focused histories and physical exams, develop reasoned differentials, and maximize care plans. Providing a foundational experience for these essential skills will help to establish standardized expectations despite variable medical school experiences.

Methods: During an orientation block, interns participated in a standardized patient experience.  Interns were presented with three common chief complaints: abdominal pain; chest pain; and headache. Faculty observed the three patient encounters and provided immediate verbal and written feedback to the interns based on a standardized grading rubric.

Results: All residents that participated “agreed” or “strongly agreed” that the experience was a meaningful educational experience. 90% of the interns reported the experience would change their clinical practice. Additionally, 75% of residents survyed one year after the experience felt the experience changed their clinical practice. Faculty felt the learning experience allowed them to address knowledge gaps early and provide early guidance where needed.

Conclusion: This article describes an emergency medicine residency program’s effort to provide a foundational experience for interns in evaluating emergency department patients. The intent was to “level the playing field” and establish “good habits” early in intern year with the realization that prior experiences vary significantly in July of intern year.