In busy emergency departments (EDs), it can be difficult for faculty to teach students amid pressure to provide patient care and conduct research. As a result, medical student teaching may be an afterthought rather than a priority, and there is a lack of focus on how students spend their time during clinical shifts in the ED. Students want to contribute to departmental workflow, but can be hampered by systems limitations and lack of clinical knowledge. One solution is for faculty and medical students to partner to add value to patient care in the ED. However, faculty and students must be wary of the distinction between activities that add value and "scutwork," tasks that involve little learning and do not require medical expertise.In this perspective, the student, resident, and faculty authors discuss learner and educator perspectives for how medical students can be productive contributors to patient care in the ED without being subjected to scutwork. They also recommend ideas for productive student activities that promote learning, contrasted with examples of scutwork to avoid. Definitions of value-added activities and scutwork depend on the learner's experience level and interests and are subject to debate. However, if medical students can be engaged in learning while also providing meaningful contributions to patient care, students, educators, and patients stand to benefit.

Study Objective: Among patients diagnosed with acute pulmonary emolism (PE), females tend to have more adverse outcomes than men (Agarwal, et al). This may be due to delays in making a timely diagnosis or the decreased utilization of novel resources such as catheter directed therapies or thrombolysis. Many medical centers have created pulmonary embolism response teams (PERTs), which have been shown to streamline patient care and facilitate access to resources (Rosovsky, et al). It is unknown if female patients receive the same resource utilization as male patients within centers with active PERTs. This study will explore the utilization of point-of-care (POC) echocardiography in patients who undergo a PERT activation in the emergency department (ED) setting. We hypothesized that female patients would have no difference in receiving a POC echo compared to their male counterparts after adjusting for the severity of illness for acute PE. It was also hypothesized that obese patients would have no difference in receiving a POC echo compared to their non-obese counterparts after adjusting for the severity of illness.Methods: Retrospective chart review was performed on patients in the Thomas Jefferson University Hospital PERT database, which compiled a list of patients for whom PERTs were called from July 2017-January 2021. Patients were eligible for the study if they had a PERT called while in the ED or if they were evaluated by a critical care physician and subsequently admitted to the intensive care unit (in lieu of a formal PERT consultation). Given the start of the coronavirus pandemic as a possible confounder, patients evaluated from March 2020 onward were excluded from this study. This narrowed down the sample size to 90 patients. Demographic, clinical, and outcome variables were collected and de-identified for all patients in an excel spreadsheet and saved to a secure university drive.Results: POC echo was performed in 25/37 (67.6%) male patients and 37/53 (69.8%) female patients (p-value 0.82). Adjusted analysis of POC echo utilization between sexes was performed for age, PESI score, and race (odds ratio [OR] 1.611, 95% confidence interval [CI] 0.580-4.471). The average BMI for male patients was 33.4 and 35.0 for females (p-value 0.44). Adjusted analysis of BMI was performed for age, PESI score, and race (odds ratio [OR] 0.977, 95% confidence interval [CI] 0.926-1.030).Conclusion: Although previous studies have suggested that women diagnosed with acute PE may have worse outcomes than men, there did not appear to be different rates of POC echo utilization between males and females. In addition, BMI did not appear to make a difference in whether patients diagnosed with PE received a POC echo. The results of this study suggest that patients who undergo a PERT evaluation receive similar resource utilization as it relates to POC echo, regardless of sex or BMI. The source of such discrepancy in patient outcomes may be further explored via utilization of other resources or via other diagnostic variables. However, larg...

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