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Over the past 20 years, there has been a global movement within postgraduate medical training toward competency-based medical education (CBME). 1 A key component of CBME is workplacebased assessment (WBA), which includes observation of trainees. 1,2 Observation during WBA has traditionally been distinguished into two types: direct and indirect. 3 Direct observation has been broadly defined as the active process of watching trainees perform to develop an understanding of how they apply their knowledge and skills to clinical practice. 4 Conversely, indirect observation comprises observations that occur when the supervisor has not directly watched

Introduction. Many Emergency Departments (ED) publish wait times; however, the patient perspective in what information is requested and the quantity of information to post is limited. Methods. We conducted a mixed-methods study at a tertiary care academic center. First, we conducted focus groups of 7 patients. We then generated themes following content analysis to create a patient survey. We administered in-person surveys to patients in ED waiting rooms at sites randomized for survey administration. We used preassigned shifts utilized for even patient perspective representation of the 24 hours-a-day/7 days-a-week service. We included waiting room patients over 18 years of age and excluded patients directly referred to a specialty service or who did not speak French or English. We analyzed survey data using descriptive statistics. Results. We identified nine dominant focus group themes: wait time definition, wait time notification, communication, education, patient expectations, utilization of the ED, patient behaviour, physical comfort, and patient empowerment. Of the 240 patient questionnaires administered, 81.3% of respondents wanted to know ED wait times before hospital arrival hospital and 90.8% wanted ED wait times posted in the waiting room. Website (46.7%) was the most popular choice for publishing wait times outside the ED. Within the ED, patients had no preference regarding display modality, if times were displayed (39.6%). Overall, 76.7% stated that their satisfaction with the ED would be improved if wait times were posted. Conclusion. ED patients strongly supported having access to wait time information. Patients believed having wait time information will have a positive impact on their overall ED satisfaction.

Background: A key component of competency-based medical education is workplacebased assessment, which includes observation (direct or indirect) of residents. Direct observation has been emphasized as an ideal form of assessment yet challenges have been identified that may limit its adoption. At present, it remains unclear how often direct and indirect observation are being used within the clinical setting. The objective of this study was to describe patterns of observation in an emergency medicine competency-based program 2 years postimplementation. Methods: Emergency medicine residents (n = 19) recorded the type of observation they received (direct or indirect) following workplace-based entrustable professional activity (EPA) assessments from December 15, 2019, to April 30, 2020. Assessment forms were reviewed and analyzed to describe patters of observation. Results: Assessments were collected on all 19 eligible residents (100% participation). A total of 1,070 EPA assessments were completed during the study period, of which 798 (74.6%) had the type of observation recorded. Of these recorded observations, 546 (68.4%) were directly observed and 252 (31.6%) were indirectly observed. The 11. Ten Cate O, Hart D, Ankel F, et al. Entrustment decision making in clinical training.