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Objective: Clinical supervision is an essential part of post‐graduate medical training. The current study investigated emergency medicine trainees' experiences and preferences regarding distant supervision via information and communication technology (ICT). Methods: Four emergency medicine trainees completed a 6‐month placement, one at a time, at a rural urgent care centre. Trainees were remotely supervised by emergency physicians located at another ED using ICT. Trainees recorded the frequency and content of their distant supervision experiences. Trainees also completed semi‐structured interviews before and after the placement to describe their experiences and preferences regarding distant supervision. Quantitative data were analysed descriptively using counts and proportions. Qualitative data were analysed using the principles of thematic analysis. Results: Trainees provided care to 1458 patients and communicated with a supervisor for 126 (8.6%) patients. Phone or audio‐visual ICT was used for 111 (88.1%) and 12 (9.5%) patients, respectively. Trainees described the placement as a unique learning experience that demanded independent practice, enhanced their communication and leadership skills and increased their confidence. The trainees also described disadvantages to the placement such as reduced quality and quantity of communication with supervisors, ICT failure and the supervisor's inability to provide hands‐on assistance. Trainees provided their perspectives on the essential requirements of a successful remote placement that involved distant supervision. Conclusions: According to trainees, distant supervision had positive and negative effects on their supervision experiences, professional development and on patient management. Trainees used ICT infrequently. The trainee's perspectives on the ideal components of a remote placement programme are presented. [ABSTRACT FROM AUTHOR]

Objective: To determine current clinical practices for managing behavioural emergencies within Victorian public hospital EDs. Methods: A multi‐centre retrospective study involving all patients who attended ED in 2016 at the Alfred, Ballarat, Dandenong, Geelong and Royal Melbourne Hospitals. The primary outcome was the rate of patient presentations with at least one restrictive intervention. Secondary outcomes included the rate of security calls for unarmed threats (Code Grey), legal status under the Mental Health Act at both the time of ED arrival and the restrictive intervention, and intervention details. For each site, data on 100 patients who had a restrictive intervention were randomly extracted for indication and methods of restraint. Results: In 2016, 327 454 patients presented to the five EDs; the Code Grey rate was 1.49% (95% CI 1.45–1.54). Within the Code Grey population, 942 had at least one restrictive intervention (24.3%, 95% CI 23.0–25.7). Details were extracted on 494 patients. The majority (62.8%, 95% CI 58.4–67.1) were restrained under a Duty of Care. Physical restraint was used for 165 (33.4%, 95% CI 29.3–37.8) patients, 296 were mechanically restrained (59.9%, 95% CI 55.4–64.3), median mechanical restraint time 180 min (IQR 75–360), and 388 chemically restrained (78.5%, 95% CI 74.6–82.0). Conclusions: Restrictive interventions in the ED largely occurred under a Duty of Care. Care of patients managed under legislation that covers assessment and treatment of mental illness has a strong clinical governance framework and focus on minimising restrictive interventions. However, this is not applied to the majority of patients who experience restraint in Victorian EDs. [ABSTRACT FROM AUTHOR]