Parent attitudes towards medical student review of children waiting for Emergency Department assessment

2013 
Background Increases in the numbers of medical students and in the workload of nonconsultant hospital doctors (NCHDs) has resulted in reduced learning opportunities for undergraduate medical trainees on the wards. We propose that patients awaiting NCHD review in the Emergency Department (ED) could be assessed by medical students, as a method of enhancing patient-centred education. As an initial step, we aimed to ascertain if parents would be amenable to this in the paediatric ED setting. METHODS Over 50,000 children attend The Children’s University Hospital’s ED annually. Parents of patients awaiting review in this ED completed questionnaires outlining attitudes towards an initial review by medical students. We also recorded the child’s presentation, age, time spent waiting in Aand E and the time of day. RESULTS All (n=100) parents approached agreed to participate in this study. 91% would have allowed a medical student to see their child while waiting. We stratified parents’ responses by their age (mean 4.7, SD 4.1), hours spent in Aand E (mean 1.73 hours, SD 1.81) and clinical presentation. The most common presentations were acute respiratory illness, gastroenteritis and minor trauma, accounting for 58% of the total. There was no consistent factor that increased the likelihood of a negative response. CONCLUSIONS Medical student assessment of patients awaiting NCHD review in the paediatric ED would provide an excellent learning opportunity. Feedback to enhance learning would be guaranteed as all patients would subsequently be assessed by an NCHD, and prompt learning points would efficiently be imparted. We have shown that parents would be open to the Introduction of this in a paediatric setting. Potential difficulties with the Introduction of this include limited space in many EDs and the need for close supervision to ensure that evolving severe illness in a previously medically unassessed patient is detected.
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