Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education

Introduction: The effects of non-physician practitioners (NPP) such as physician assistants and nurse practitioners on the education of emergency medicine (EM) residents have not previously been specifically evaluated. Emergency medicine societies have made policy statements regarding NPP presence in EM residencies without the benefit of empiric studies. Methods: A cross-sectional, mixed methods questionnaire with strong validity evidence was distributed to current EM residents who were members of a large national society, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), between June 4–July 5, 2021. Results: We received 393 partial and complete responses, representing a 34% response rate. A majority of respondents (66.9%) reported that NPPs have a detracting or greatly detracting impact on their education overall. The workload in the emergency department was reported generally as lighter (45.2%) to no impact (40.1%), which was cited in narrative responses as an aspect of both enhancing and detracting from resident physician education. Non-physician practitioner postgraduate programs in EM were associated with a 14x increase in the median number of procedures forfeited over the course of the prior year (median = 7.0 vs 0.5, P