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Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures

Introduction: At present, there exists no standard orthopedic training for emergency medicine (EM) residency programs. Varying residency environments including but not limited to volume, acuity, and competing residency programs will dictate the number of orthopedic procedures a resident is exposed t...

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Autores principales: Blazar, Eric, Jones, Bernard, Behgam, Babak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270499/
https://www.ncbi.nlm.nih.gov/pubmed/34277176
http://dx.doi.org/10.7759/cureus.15551
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author Blazar, Eric
Jones, Bernard
Behgam, Babak
author_facet Blazar, Eric
Jones, Bernard
Behgam, Babak
author_sort Blazar, Eric
collection PubMed
description Introduction: At present, there exists no standard orthopedic training for emergency medicine (EM) residency programs. Varying residency environments including but not limited to volume, acuity, and competing residency programs will dictate the number of orthopedic procedures a resident is exposed to, ultimately dictating a graduate’s comfort level with orthopedic procedures. Our study set out to investigate further whether training alongside an orthopedic residency affects an attending physician’s perceived procedural comfort. Methods: This is a cohort study utilizing a 14-question survey distributed to an online community of EM physicians to examine the relationship between training at a residence program alongside orthopedic residents, the utility of an elective orthopedic rotation, and the overall confidence in managing closed reductions. Results: EM physicians trained at a program that also hosted an orthopedic residency were more likely to train at large academic tertiary care centers (78%). Forty-two percent of these respondents felt that the presence of an orthopedic residency had a negative impact on their overall orthopedic training. The remaining 58% felt that the orthopedic residency had a positive impact on their procedural skills. In our study, the overall mean comfort level was statistically significant (p-value = 0.0024) higher in those who trained without orthopedic residents (8.78) compared to those who trained alongside an orthopedic residency (7.61). Those who had an elective orthopedic rotation found it to be more beneficial if they did the rotation with an orthopedic residency (p-value = 0.0329). Those who reported a beneficial orthopedic rotation also reported a higher level of confidence in the management of non-fracture reductions (p < 0.011, ρ = .25). Conclusion: Seeing as though both training and practice environments for emergency physicians vary greatly across the country, every effort should be taken to ensure graduating residents are prepared to perform orthopedic procedures without the assistance of orthopedic surgeons. Irrespective of whether a program has in-house orthopedic residents or not, EM residents should take it upon themselves to maximize their time during residency to focus on these core competencies. Graduates at the greatest risk of having low confidence are trained at academic centers that also host orthopedic programs. One should be cognizant of this while going through their EM residency.
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spelling pubmed-82704992021-07-15 Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures Blazar, Eric Jones, Bernard Behgam, Babak Cureus Emergency Medicine Introduction: At present, there exists no standard orthopedic training for emergency medicine (EM) residency programs. Varying residency environments including but not limited to volume, acuity, and competing residency programs will dictate the number of orthopedic procedures a resident is exposed to, ultimately dictating a graduate’s comfort level with orthopedic procedures. Our study set out to investigate further whether training alongside an orthopedic residency affects an attending physician’s perceived procedural comfort. Methods: This is a cohort study utilizing a 14-question survey distributed to an online community of EM physicians to examine the relationship between training at a residence program alongside orthopedic residents, the utility of an elective orthopedic rotation, and the overall confidence in managing closed reductions. Results: EM physicians trained at a program that also hosted an orthopedic residency were more likely to train at large academic tertiary care centers (78%). Forty-two percent of these respondents felt that the presence of an orthopedic residency had a negative impact on their overall orthopedic training. The remaining 58% felt that the orthopedic residency had a positive impact on their procedural skills. In our study, the overall mean comfort level was statistically significant (p-value = 0.0024) higher in those who trained without orthopedic residents (8.78) compared to those who trained alongside an orthopedic residency (7.61). Those who had an elective orthopedic rotation found it to be more beneficial if they did the rotation with an orthopedic residency (p-value = 0.0329). Those who reported a beneficial orthopedic rotation also reported a higher level of confidence in the management of non-fracture reductions (p < 0.011, ρ = .25). Conclusion: Seeing as though both training and practice environments for emergency physicians vary greatly across the country, every effort should be taken to ensure graduating residents are prepared to perform orthopedic procedures without the assistance of orthopedic surgeons. Irrespective of whether a program has in-house orthopedic residents or not, EM residents should take it upon themselves to maximize their time during residency to focus on these core competencies. Graduates at the greatest risk of having low confidence are trained at academic centers that also host orthopedic programs. One should be cognizant of this while going through their EM residency. Cureus 2021-06-09 /pmc/articles/PMC8270499/ /pubmed/34277176 http://dx.doi.org/10.7759/cureus.15551 Text en Copyright © 2021, Blazar et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Blazar, Eric
Jones, Bernard
Behgam, Babak
Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title_full Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title_fullStr Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title_full_unstemmed Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title_short Presence of Orthopedic Residency Decreases Emergency Physician’s Confidence in Orthopedic Procedures
title_sort presence of orthopedic residency decreases emergency physician’s confidence in orthopedic procedures
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270499/
https://www.ncbi.nlm.nih.gov/pubmed/34277176
http://dx.doi.org/10.7759/cureus.15551
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