Professional Development
Observable Behaviors and Strategies of Efficient Emergency Physicians: A Scoping Review
Trépanier et alCJEM
Efficiency in the emergency department is critical for patient flow and clinical care, yet it remains challenging to cultivate and is inconsistently taught across emergency medicine residency programs. To identify observable and teachable behaviors associated with efficient emergency physicians, investigators conducted a scoping review from January 1, 2015, to July 1, 2025, adhering to the Joanna Briggs Institute (JBI) methodology across Medline/PubMed, Embase, Google Scholar, and gray literature.
From an initial screening of 6,343 records, 20 studies satisfied full inclusion criteria. The review identified no clear, universally accepted definition of emergency department efficiency, resulting in the use of heterogeneous proxy measures across the literature to evaluate efficiency-related outcomes.
Although no included study directly demonstrated a specific set of strategies that improve efficiency, analysis revealed six core behavioral themes: communication, targeted investigations, documentation practices, clinical teaching skills, cognitive flow management, and physical movement efficacy. Each theme encompassed specific behaviors that either promoted or impeded clinical efficiency. The collective evidence suggests that physician efficiency may largely depend on optimizing the initial clinical encounter through effective communication, clinical reasoning, and shared decision-making. These insights serve as a preliminary foundation for the planned development of a standardized observational assessment tool.
Key Takeaways
- In an analysis of 20 included studies from 6,343 screened records, efficient emergency physicians showed greater effectiveness across six behavioral domains: communication, targeted investigations, documentation strategies, clinical teaching skills, cognitive flow management, and physical movement efficacy.
- The identified physician behaviors suggest that emergency department efficiency may largely depend on optimizing the initial patient encounter via effective communication, clinical reasoning, and shared decision-making.