Use of graded responsibility and common entrustment considerations among United States emergency medicine residency programs

Jason Lai; Benjamin Holden Schnapp; David Simon Tillman; Mary Westergaard; Jamie Hess; Aaron Kraut

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자료유형: 학술저널

저자정보: Jason Lai (University of Wisconsin School of Medicine and Public Health) Benjamin Holden Schnapp (University of Wisconsin School of Medicine and Public Health) David Simon Tillman (University of Wisconsin School of Medicine and Public Health) Mary Westergaard (University of Wisconsin School of Medicine and Public Health) Jamie Hess (University of Wisconsin School of Medicine and Public Health) Aaron Kraut (University of Wisconsin School of Medicine and Public Health)

저널정보: 한국보건의료인국가시험원 Journal of Educational Evaluation for Health Professions Journal of Educational Evaluation for Health Professions Vol.17

발행연도: 2020.1

수록면: 1 - 7 (7page)

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Purpose: The Accreditation Council for Graduate Medical Education (ACGME) requires all residency programs to provide increasing autonomy as residents progress through training, known as graded responsibility. However, there is little guidance on how to implement graded responsibility in practice and a paucity of literature on how it is currently implemented in emergency medicine (EM). Wesought to determine how EM residency programs apply graded responsibility across a variety of activities and to identify which considerations are important in affording additional responsibilities to trainees. Methods: We conducted a cross-sectional study of EM residency programs using a 23-question survey that was distributed by email to162 ACGME-accredited EM program directors. Seven different domains of practice were queried. Results: We received 91 responses (56.2% response rate) to the survey. Among all domains of practice except for managing critically illmedical patients, the use of graded responsibility exceeded 50% of surveyed programs. When graded responsibility was applied,post-graduate year (PGY) level was ranked an “extremely important” or “very important” consideration between 80.9% and 100.0% ofthe time. Conclusion: The majority of EM residency programs are implementing graded responsibility within most domains of practice. Whendecisions are made surrounding graded responsibility, programs still rely heavily on the time-based model of PGY level to determineadvancement.

#Cross-sectional studies #Emergency medicine #Internship and residency #Medical education #United States

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