Assessment of Teacher Interruptions on Learners during Oral Case Presentations

Background:Studies have only recently begun to investigate the effects of interruptions on physicians in the emergency department (ED). Objectives:To determine the frequency and nature of interruptions by the training physician that occur when medical trainees do oral case presentations (OCPs) in the ED. Methods:This was an observational study. Learner OCPs to attending emergency physicians were observed in the ED of an urban Level 1 trauma center at a major teaching hospital. A single investigator followed attending physicians blinded to the study objective in a nonrandomized convenience sampling of all ED shifts, recording information regarding teacher interruptions during new patient presentations. Learners completed a brief questionnaire after each OCP. Results:A total of 196 OCPs were observed. The mean (±SD) duration of OCPs was 3.30 (±1.85) minutes, and the mean (±SD) number of interruptions was 0.75 (±0.60) per minute and 2.49 (±1.95) per OCP. The number of interruptions (per OCP) and duration of OCP varied by learner level of training, with more experienced learners giving shorter presentations and being interrupted less often. Frequency (per minute) of interruptions did not vary by learner level. In 40.3% of OCPs, attending physicians interrupted to give an assessment and/or a plan before the learner had done so, but 8.3% of interrupted learners believed that teacher interruptions were “disruptive” to their OCP. Conclusions:Attending emergency physicians frequently interrupt learners during new patient OCPs, with the number of interruptions varying by learner level of training. Teacher interruptions appear to have minimal, if any, detrimental effect on the perceived effectiveness of OCPs as a learning experience.