• Philip Shayne, Michelle Lin, Jacob W Ufberg, Felix Ankel, Kelly Barringer, Sarah Morgan-Edwards, Nicole DeIorio, and Brent Asplin.
• Department of Emergency Medicine, Emory University, Atlanta, GA, USA. pshayne@emory.edu
• Acad Emerg Med. 2009 Jan 1;16(1):76-82.

AbstractEmergency department (ED) crowding is a national crisis that contributes to medical error and system inefficiencies. There is a natural concern that crowding may also adversely affect undergraduate and graduate emergency medicine (EM) education. ED crowding stems from a myriad of factors, and individually these factors can present both challenges and opportunities for education. Review of the medical literature demonstrates a small body of evidence that education can flourish in difficult clinical environments where faculty have a high clinical load and to date does not support a direct deleterious effect of crowding on education. To provide a theoretical framework for discussing the impact of crowding on education, the authors present a conceptual model of the effect of ED crowding on education and review possible positive and negative effects on each of the six recognized Accreditation Council for Graduate Medical Education (ACGME) core competencies.

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