Novice Doctors in the Emergency Department: A Scoping Review

Abstract

In many emergency departments (EDs), young, inexperienced doctors treat patients who are critically ill. At the start of their career, these novice doctors are not sufficiently qualified to take care of these potentially critically ill patients in the highly demanding environment of an ED. This not only poses a threat to the wellbeing of the doctor, who feels inadequately prepared and experiences a lot of stress, but also to that of the patients, who may not receive optimal care. Lastly, young doctors may influence the efficiency of the organization, with longer throughput times, more orders of ancillary investigations, and more admissions.Training novice doctors with regard to simple or complex skills using simulation techniques is part of the solution. However, the transfer of newly learned skills to clinical practice remains unexplored, and not everything can be trained before the actual skill is required. Therefore, it is important to train young doctors in their learning abilities, for instance, teach them how to be adaptive and how to use their skills in new situations. Lastly, the way care is organized is essential. Good supervision, leaving room for the learning processes of young doctors, developing a team with more experienced professionals (paramedics, nurses, and doctors), and well-organized processes, aiming to reduce the complexity of the work, are ways to improve the quality of care, independent of the experience level of the novice doctor.

Comparison of physicians’ and dentists’ incident reports in open data from the Japan Council for Quality Health Care: a mixed-method study

“…Sakuma et al reported that resident trainee dentists experienced more incidents of a higher level of severity than did staff dentists in Japan [18]. Almost half of the participants who were intern doctors had been assigned to tasks for which they were not trained or for which medical errors could have happened easily [19]. Medical interns are not only factors in the liveware category, which included missed treatment procedures or missed judgements, but also the environmental category, which included the lack of experienced staff and instructors.…”