Simon Craig, FACEM, GCHPE, Emergency Physician and Director of Emergency Medicine Training, Adjunct Senior Lecturer; Jonathan Dowling, FACEM, PgCertTox (Cardiff), Emergency Physician and co-Director of Emergency Medicine Training, Adjunct Lecturer.
Education and Training
‘Registrar in charge shifts’: Learning how to run a busy emergency department
Version of Record online: 11 JAN 2013
© 2013 The Authors. EMA © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia
Volume 25, Issue 2, pages 168–174, April 2013
How to Cite
Craig, S. and Dowling, J. (2013), ‘Registrar in charge shifts’: Learning how to run a busy emergency department. Emergency Medicine Australasia, 25: 168–174. doi: 10.1111/1742-6723.12042
- Issue online: 7 APR 2013
- Version of Record online: 11 JAN 2013
- Manuscript Accepted: 27 NOV 2012
- emergency medicine;
In Australasia, emergency registrars usually gain experience ‘running’ an ED overnight – without supervision. This paper describes the introduction of FACEM-supervised daytime ‘registrar in charge’ (RIC) shifts into a tertiary adult ED over a 6 month period.
Each registrar was allocated at least one RIC shift during their 13 week ED term. Structured questionnaires gathered data regarding the educational impact of the shifts, any adverse effects on departmental function, changes to work practices, and perceptions of teaching and learning. Data were analysed using thematic analysis.
During the study period, 16 senior ED registrars were rostered for 26 RIC shifts. Questionnaires were completed by 16/16 registrars and 13/16 emergency physicians. The RIC shifts were viewed positively by the emergency registrars – 93% reported useful feedback, felt that the shifts provided a good insight into their workplace behaviour, and that they should be rolled out across other departments. FACEMs were also positive in their evaluation, and reported little negative impact on departmental function. Major themes identified by both registrars and emergency physicians included communication skills, knowledge and experience, delegation, professionalism and organisational skills. Additional themes that were more prominent in FACEM responses included multitasking, dealing with interruptions, managing patient flow and being aware of the whole department.
RIC shifts are a feasible and acceptable method to teach running the floor in the ED. Further study should assess impact on patient outcomes.