Mr Ioannides and colleagues1 examined 15 years of emergency department (ED) data and determined that length of stay was 5 minutes longer when medical students were present vs when they were absent. We agree that this is unlikely to be clinically significant.
The authors provided substantial ED data, acknowledged the absence of visit-level data, but omitted what the students actually did during their clerships. They stated “… students were assigned approximately nine 8- to-12-hour shifts over 3 weeks, during which they were expected to evaluate and follow-up several patients presenting to the ED.”
The setting of Drs McGettigan and McKendree’s study evaluating the association between the presence of students and outcomes was a rehabilitation unit,1 which is a very different setting from the EDs of our study. The ED comprises inherently dissimilar patient encounters requiring rapid evaluation, decision making, and intervention for undifferentiated acute complaints.
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