EHR Data Show Residents Complete Consultations Faster with Experience

Acker RC, Bradford CT, Perron IJ, Rosenthal JW, et al. Automated Point-Of-Care Assessment Metrics for Surgical Residents Performing Consultations: A Pilot Study. J Am Coll Surg. September 2026

Electronic health record (EHR) metadata may offer an automated way to assess surgical resident consultation performance, supplementing evaluations that depend largely on faculty observation.

Acker et al. examined EHR audit logs for 58 postgraduate-year-2 general surgery residents who performed 19,139 adult consultations across three hospitals between July 2020 and June 2025. Researchers measured consultation duration and medication reconciliation, comparing residents’ first 50 consultations with consultations 150–200. Analyses adjusted for patient characteristics, consultation reason, hospital, care setting, shift assignment, and workload.

Median consultation duration was 3.4 hours, and medication reconciliation was completed in 71% of consultations. Both measures varied significantly among residents, with reconciliation completion ranging from 47% to 86%. Resident rankings were similar before and after risk adjustment.

With greater experience, residents completed consultations 18% faster (p = 0.002), and their consultation times became more consistent. Medication reconciliation completion did not change significantly (p = 0.22), suggesting that experience affected the two measures differently.

The authors concluded that EHR metadata may provide objective performance measures across substantial numbers of encounters. Further validation and expansion into additional performance domains are needed before this approach can complement existing assessments and provide residents with timely feedback to inform their practice.