Assessment of Written Feedback for Emergency Medicine Residents.

OBJECTIVES: An essential component of resident growth is a learning environment with high-quality feedback. Criteria have been developed for characterizing and assessing written feedback quality in internal medicine residents by Jackson et al. Our primary goal was to describe feedback characteristics and assess the quality of written feedback for emergency medicine (EM) residents. Our secondary goals were to evaluate the relation between feedback quality and objective outcome measures. METHODS: This retrospective study was conducted between July 1, 2016 and July 1, 2018. EM residents with an Accreditation Council for Graduate Medical Education composite score (ACS), an in-service score, and written evaluations completed by an attending physician or EM resident in each of the 2 years of the study period were included. RESULTS: Overall, most of the evaluations contained 1 (21%), 2 (23%), or 3 (17%) feedback items. Feedback tended to be positive (82%) and the feedback quality of the evaluations was more likely to be high (44%). There was an association between feedback quality and ACS change (P < 0.0001), but not in-service score change (P = 0.63). Resident evaluations were more likely than attending evaluations to correlate with ACS change (P < 0.00001). CONCLUSIONS: The written evaluations contained few individual feedback items. Evaluations generally focused on the feedback characteristics of professionalism and interpersonal communication. The general feedback quality of evaluations tended to be high and correlated with an increase in ACSs.

Incidence and pathology of repeat CT abdomen and pelvis in an adult emergency department population.

INTRODUCTION: Our objective was to identify the incidence of adult patients who undergo more than one computed tomography (CT) abdomen and pelvis within 1 year and detect the incidence of significant pathology on these repeat scans. METHODS: All adults with an initial CT within 12 months and then during an emergency department visit were retrospectively identified. RESULTS: A percentage of 21.1 of the repeat CT scans were positive. Approximately 20% of positive repeat CT scans occurred within the first month and nearly 70% within 6 months of the initial CT scan. CONCLUSIONS: Many patients undergo multiple CT scans within a 1 year time frame with significant pathology identified.