Self-Assessment of Preparedness: Incoming Emergency Medicine Interns in the Era of COVID-19
Abstract
Learning Objectives: The purpose of this study was to assess the preparedness of the incoming emergency medicine intern (EM-1) resident class in light of changes to clinical rotations incurred by COVID-19. This feedback was given to programs to alter orientation programs and address knowledge gaps.
Background: The COVID-19 pandemic resulted in modification, limitation or cancellation of rotations that affected the clinical experience of graduating fourth-year medical students (MS4).
Objective: The purpose of this study was to assess the preparedness of the incoming emergency medicine intern (EM-1) resident class in light of changes to clinical rotations incurred by COVID-19.
Methods: We conducted a prospective, survey-based assessment of MS4 matriculating into 7 geographically distinct US EM residency programs in July 2021. The anonymous survey collected data on respondent demographics, rotations, procedures performed, and subjective comfort level with clinical scenarios. Each respondent was assigned a procedural index score (PS) and a clinical comfort index score (CCS), defined as the total sums of reported procedure counts and the quantitative Likert values for each clinical scenario, respectively. Spearman’s rank order coefficient was used to assess correlation between the index scores (PS, CCS) and educational variables.
Results: A total of 63 respondents returned completed surveys. The median numbers of EM rotations, virtual rotations and ED encounters were 2 (IQR 2-2), 3 (IQR 1-4,) and 100 (IQR 55-100), respectively. MS4 rotations were “somewhat” or “moderately” limited due to COVID-19 for 82.5% of respondents and “somewhat” or “moderately” suspended in 73.0%. Calculation of index scores yielded a median PS=35 (IQR 30-39) and CCS=30 (IQR 27-32). PS was significantly positively correlated with the number of EM rotations (r=0.395) p=0.001), and ED patient encounters (r=0.369, p=0.006).
Conclusion: Based on self-reported data, changes to MS4 rotations did not significantly impact the procedural exposure or clinical comfort level of incoming EM-1 residents. Procedural experience, but not overall clinical comfort level, was positively correlated with the number of EM rotations and patient encounters completed.