A Research Agenda for Studying the Effect of Emergency Department Crowding on Clinical Education

Much of the specialty training for emergency medicine (EM) residents and a substantial portion of the ambulatory care education and training for upper-level medical students and non-EM residents occur in emergency departments (EDs).ED crowding is an important problem for the specialty of EM, medical education, and health care in general.The effects of crowding on education and training in the ED are unknown.The challenge for EM in studying the effects of crowding on education and training is to use validated measures of crowding, clinical teaching, and educational outcomes in a wide sample of EDs.This article reviews the literature on ED crowding and clinical teaching in EM, and proposes a research agenda for studying the effects of ED crowding on education. SEARCH STRATEGYOur literature search was extensive, but a comprehensive exploration of all relevant literature is beyond the scope of this commentary.We searched PubMed using the terms clinical education and outcome, education and emergency medicine, emergency medicine and overcrowding, and emergency medicine and crowding.Titles were reviewed for relevance, and potentially usable articles were obtained for full-text review.Reference lists from the selected articles were reviewed for additional articles not revealed by the electronic search.Finally,