A survey of teaching and the use of clinical guidelines in accident and emergency departments.

OBJECTIVE: To investigate organised teaching in accident and emergency (A&E) departments in England and Wales. METHODS: A survey was carried out by postal questionnaire. Directed to senior house officers (SHOs), the questionnaire examined the nature and extent of departmental teaching, and measured the availability, suitability, and actual use made of guidelines. Of 231 questionnaires sent, 164 were returned (response rate 71%). RESULTS: The results show that most SHOs attended A&E induction courses at the beginning of their attachments, although the scope of these coursed varied widely. Most SHOs also received regular teaching, although the programmes were generally of less than 3 h in duration. The majority of respondents were well supported with written documentation in a variety of formats. However, a significant minority (29%) of SHOs requested more detailed clinical guidance, and these tended to be the respondents who received the most departmental teaching. CONCLUSIONS: More time could be allocated to structured teaching than at present, and greater use made of complementary educational methods such as practical skill teaching, case presentation, clinical audit, and involvement in journal clubs. More extensive departmental teaching should also be supported by making available more detailed and comprehensive clinical guidelines.