Background:
Bedside teaching is the ideal venue for teaching interpersonal skills and physical examination techniques and modeling professionalism. Hospitalists have an increasing influence on the inpatient education of internal medicine residents and medicine clerkship students but receive little formal training in this endeavor. We studied the effects of a faculty development program on time hospitalist attendings spend at the bedside and the frequency of physical examination teaching during teaching rounds.
Methods:
Five 1‐hour skill‐based sessions on teaching the physical examination were offered to a 28‐member group of academic hospitalists who serve as the teaching attendings on 4 general medicine teams. These “teaching‐to‐teach” sessions were led by expert clinicians and covered the cardiac, pulmonary, abdominal, joint, and neurologic exams. An introductory session addressed current practices and attitudes, obstacles, and best bedside teaching practices. Medical residents observed and reported behavior of their hospitalist attendings on teaching rounds for 5 weeks before and after the faculty development program. Residents replied to a daily weekday e‐mail reporting total time spent with their hospitalist attending during teaching rounds, time spent inside patient rooms during attending rounds, and whether a physical examination finding or skill was demonstrated by their attending.
Results:
Fifty‐nine residents made a total of 140 observations during hospitalist attending rounds (74% response rate). Residents reported that their attendings went to the bedside more often after the faculty development program [58 of 79 rounds (73%) vs. 37 of 61 rounds (61%), P = 0.14] and demonstrated more physical examination teaching (53% vs. 38% of rounds, P = 0.10). Total time spent on rounds by the hospitalists did not change after the intervention (102 vs. 101 minutes on average). However, there were significant and substantial increases in the mean amount of time inside patient rooms (32 vs. 17 minutes, P = 0.001) and fraction of teaching time spent at the bedside (31% vs. 17%, P < 0.001) following the intervention.
Conclusions:
This study of rounding behavior of hospitalist attendings suggests that a faculty development program promoting bedside teaching and teaching the physical examination can significantly increase total time and fraction of time spent at the bedside during teaching rounds. There was a nonsignificant increase in the frequency of bedside teaching and physical examination teaching.
Author Disclosure:
C. Crumlish, none; M. Yialamas, none; G. McMahon, none.