Emergency Department Boarding INitiative Gamification Overhaul (ED-BINGO).

Abstract

Background: Boarding of patients in the Emergency Department (ED) impedes patient flow through the department and deprives medical students of valuable educational opportunities. We designed a curriculum for medical students during their required Emergency Medicine (EM) clerkships aimed to circumvent lost educational opportunities. Participants should gain increased appreciation of interprofessional collaboration, procedural competency, and ED flow.

Methods: Students learned of the optional curriculum as they began their required EM clerkship. From August 2023 through January 2024, 120 students were contacted for recruitment into the optional curriculum. Students were provided with an ED-BINGO card with 25 pre-identified patient care activities deemed relevant to EM across 5 different categories. Participants were surveyed regarding educational value and enjoyment on a 5-point Likert scale.

Results: The 32 fully completed surveys were evaluated (26.7%), and 16 students (13.4%) reported using the ED-BINGO card during their EM clerkships. Participants reported that the ED-BINGO card tasks were appropriate for their level of training (median: 5, interquartile range (IQR): 1, mean 4.56, standard deviation (STD) 0.68), enhanced their understanding of flow/throughput of the ED (median: 4, IQR: 1.75, mean 3.94, STD 1.22), improved their knowledge/skills (median: 4, IQR: 2, mean 4, STD 1.06), helped them feel more valuable to the team (median score: 5, IQR: 2, mean 3.89, STD 1.49), and should remain a permanent fixture of the rotation (median: 4.5, IQR: 1, mean 4.5, STD 1.01).

Conclusions: The ED-BINGO activity for the EM clerkship was perceived by medical students as educationally beneficial and enjoyable. While the limited number of participant respondents precludes any definitive conclusions about its broader effectiveness or its suitability for formal incorporation into the clerkship, the warm reception, especially noted in our student narrative responses, shows promising opportunities for other clerkships to adopt similar activity-driven gamification for self-driven adult learners. Further study with greater response rates would determine whether gamified interventions can meaningfully mitigate the educational challenges posed by ED boarding.