# Implementation of a Resident Pod Associated With Increased Patient Encounters and Critical Procedures for Emergency Medicine Residents in a Community ED

## TL;DR

A new clinical structure called a Resident Pod increased patient encounters and critical procedures for emergency medicine residents in a community hospital.

## Contribution

The study introduces and evaluates a Resident Pod system to enhance resident training in community-based emergency medicine programs.

## Key findings

- Resident Pod implementation significantly increased patient encounters for PGY-1 residents and all residents combined.
- Critical procedures performed by residents also increased significantly after the Pod was introduced.
- PGY-2 residents saw more patients in the Pod, though this increase was not statistically significant.

## Abstract

Background

Currently, there are varied clinical workflows throughout Emergency Medicine (EM) training programs, without recommendations that optimize resident learning opportunities. Furthermore, newer, community-based programs often have difficulty integrating residents into existing workflows. It is critical for EM training programs to optimize opportunities to perform advanced, critical procedures and to provide adequate patient volumes for their residents.

Methods

This is a retrospective, observational study conducted in a single, community-based ED. Data were collected for 1 year prior to the implementation of a Residency Pod (R Pod) and for 1 year after implementation. Postgraduate Year (PGY)-1 and PGY-2 classes were used in each data set. There were eight residents in each class, for a total of 16 residents for each timeframe. The median number of patients seen per month, as well as critical procedures per month, was calculated. The Wilcoxon rank-sum test was utilized to determine statistical significance.

Results

There was a statistically significant increase in both patient encounters per month and critical procedures performed by residents per month. For patient encounters, statistical significance was obtained for the PGY-1 residents (p=0.004) and for all residents (p=0.022). Procedures increased for PGY-1s (p=0.002), PGY-2s (p=0.041), and all residents (p=0.002). PGY-2 residents saw more patients in the R Pod, but this did not achieve statistical significance.

Conclusion

The creation and implementation of an R Pod resulted in increased patient volumes and increased opportunities to perform critical procedures for EM residents when compared to a round-robin patient assignment system. Although this is a small, single-center study, consideration of utilizing an R Pod clinical structure may be warranted for new, community-based EM residency programs.