The Effect of Clinical Experience on the Error Rate of Emergency Physicians - 21/08/11

Doi : 10.1016/j.annemergmed.2008.01.329

William A. Berk, MD ^⁎ , Robert D. Welch, MD, Phillip D. Levy, MD, Jamira T. Jones, MD, Crystal Arthur, MD, Gloria J. Kuhn, DO, Jeffrey J. King, MD, Brooks F. Bock, MD, Padraic J. Sweeny, MD
Emergency Department, Detroit Receiving Hospital and Department of Emergency Medicine, Wayne State University, Detroit, MI

Address for correspondence: William A. Berk, MD, Department of Emergency Medicine, 6G University Health Center, 4201 St. Antoine, Detroit, MI 48201; 313-745-3331

Résumé

Study objective

We assess the effect of emergency physicians' clinical experience on the propensity to commit a patient care error.

Methods

Seven years of data from a single emergency department's peer review activities were reviewed for all patient care errors made by emergency physicians. Emergency physician clinical experience was defined as years since completion of residency training during the year each error was made. A repeated-measures log-linear model was constructed that predicted error count and the rate of errors over time, with a correction for number of patients treated by each physician.

Results

Of 829 cases reviewed during 7 years, there were 374 emergency physician errors identified. Mean emergency physician experience was 8.1±8.6 years. Emergency physicians with experience of 1.5 years or more were less likely to make an error (relative risk [RR]=0.66; 95% confidence interval [CI] 0.48 to 0.91) than those who were less experienced. Errors were not associated with emergency physician age (RR=1.01; 95% CI 0.99 to 1.03) or sex (RR=1.29; 95% CI 0.93 to 1.79).

Conclusion

Emergency physicians with less than 1.5 years of clinical experience may be more likely to commit errors than more experienced emergency physicians.

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Plan

Introduction

Background

Importance

Goals of This Investigation

Materials and Methods

Setting

Study Design

Data Collection and Processing

Primary Data Analysis

Sensitivity Analyses

Results

Characteristics of Study Subjects

	Supervising editor: John C. Moorhead, MD, MS
	Author contributions: WAB, PDL, BFB, and PJS conceived the study. WAB, RDW, PDL, GJK, BFB, and PJS designed the study. WAB designed the trial. WAB drafted the article. RDW, PDL, JTJ, CA, GJK, JJK, BFB, and PJS assisted in manuscript preparation. RDW provided statistical analysis and advice. JTJ, CA, and JJK were responsible for data collection and organization. WAB takes responsibility for the paper as a whole.
	Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.
	Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedHome.com.
	Publication dates: Available online March 19, 2008.
	Reprints not available from the authors.