Implementing a Team-Based Fourth-Year Medical Student Rotation in Emergency Medicine

BACKGROUND Historically, fourth-year (M4) medical students at the Medical College of Wisconsin who were interested in emergency medicine (EM) worked with faculty in the emergency department primarily in a see-one-staff-one clinical model. Students were sent to see a patient, obtain a history and perform a physical examination and then present a summary to the faculty.1,2,3 The faculty evaluations of these student interactions constituted the majority of the student’s clinical score and clerkship grade.4 However, in the busy clinical environment of a Level I trauma center, it was challenging for faculty to dedicate one-on-one time with students. As a result, students frequently waited on busy faculty to assign them a new patient rather than proactively gaining clinical experience. Therefore, a new team-based clinical model was created after obtaining input from faculty, residents and students to increase student interactions with patients. Although similar models might exist at other programs, there was limited evidence to guide a student’s team function in the ED.5,6 As a result, it was decided to study the impact of the change on student evaluations and case logs, as well as faculty and student perceptions, all of which stood to be impacted the most by the change. Medical College of Georgia, Department of Emergency Medicine, Augusta, Georgia Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin * †