Medicine
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Observational Study
The influence of resident seniority on supervised practice in the emergency department.
To investigate the influence of resident seniority on supervised clinical practice in the emergency department (ED). This was a retrospective, 1-year cohort study conducted in 5 EDs within Taiwan largest healthcare system. All adult nontrauma visits presenting to the EDs during the day shift between July 1, 2011 and June 30, 2012 were included in the analysis. ⋯ Furthermore, compared with attending-alone visits, supervised visits with junior residents had a greater odds of ED observation (adjusted odds ratio [aOR], 1.1; 95% CI, 1.07-1.20), while supervised visits with all 3 resident-seniority groups had significantly greater odds of laboratory examinations (junior: aOR, 1.1; 95% CI, 1.03-1.16; intermediate: aOR, 1.1; 95% CI, 1.04-1.15; and senior: aOR, 1.1; 95% CI, 1.05-1.15). As resident seniority increases, less time is needed for decision making in supervised visits. However, compared to attending-alone visits, supervised visits still resulted in greater use of laboratory examinations and delayed patient disposition.