Comparison of perceived and actual times spent by residents performing ultrasound examinations on patients.

UNLABELLED: Emergency medicine (EM) ultrasonography (US) has become a part of residency education. More residents will be taking time during their shifts to perform bedside US examinations for educational purposes, thus further challenging time resources.

OBJECTIVES: The authors' hypothesis was that EM residents could accurately estimate the amount of time spent on an US examination of a patient, thus being able to determine when too much time is being taken away from other duties.

METHODS: The authors performed a prospective, single-blind observational study over a four-month period of EM residents at a large community hospital emergency department (ED) with an EM residency program. When a study physician was present, residents were observed and timed from plugging in the machine to turning it off. The residents, who were not aware of the study, were then asked how long the examination had taken. The true scan time, perceived scan time by the resident, and whether the department was busy or not were recorded on standardized quality assurance data sheets by the study physician. When all beds in the department were occupied, the ED was considered to be busy; otherwise, it was noted as not busy. Statistical analysis included descriptive statistics, paired Student's t-test to compare perceived and actual scan times, and correlation analysis to evaluate for any effect of how busy the ED was on accuracy of perceived times.

RESULTS: Ninety-three observations were made on 17 different residents. The mean perceived time of examinations was 8 min 12 sec (95% CI = 6:42 to 9:42); the mean actual time was 9 min 53 sec (95% CI = 8:29 to 11:18). The difference of 1 min 42 sec (95% CI = 0:37 to 2:47) yielded a p = 0.003. Residents underestimated the time spent on the scan 64 of 93 (69%) times. How busy the ED was did not affect accuracy.

CONCLUSIONS: In this study, residents underestimated the amount of time spent performing an ultrasound examination. The small difference between the actual and perceived scan times was statistically significant; the clinical significance of this time difference is not known.