Medical student procedures and attending faculty exposure

Background: The aim of this study was to determine whether medical students working with the same attending on multiple shifts as opposed to a variety of attendings leads to the performance of more procedures during their emergency medicine (EM) elective. Methods: This was a retrospective observational study conducted in an Emergency Department with a census of 150 000 patients per year and a 3 year EM residency. Fourth-year medical student Attendance/Procedure Logs from July 2004 to March 2007 were reviewed. Students were divided into two groups: those who worked four or more shifts with a single attending (study group) and those who worked less than four shifts with any single attending (control group). The number of procedures performed in each group was compared. Results: Of 144 medical students, 63 (43.8%) were in the study group and 81 (56.2%) were in the control group. During the study dates, medical students recorded a total of 1327 procedures. Mean number of procedures performed in the study group (12.9, 95% CI 11.7 to 14.0) was higher than in the control group (6.3, 95% CI 5.4 to 7.2). This pattern remained true in every recorded category: arterial blood gas, abscess drainage, laceration repair, lumbar puncture and nasogastric tube. Conclusion: Medical students that worked four or more shifts with a single EM attending performed twice as many overall procedures (12.9 vs 6.3) and significantly more invasive procedures than medical students who worked with a variety of attendings during their 4th-year EM elective.