Background:
Hospitalist programs are increasingly prevalent in teaching hospitals. Consequently, internal medicine and pediatrics trainees may receive much of their inpatient education from hospitalists. The objective of this study was to characterize the effects of hospitalists on trainee education.
Methods:
We searched MEDLINE, DARE, NHS EED, HTA, and Cochrane (last searched 11/2007) using the term hospitalist, as well as national meeting abstracts from SHM (2002‐2007), SGIM (2001‐2007), and Pediatric Academic Societies (2000‐2007). English‐language citations were included that met all the following: (1) involvement of hospitalists; (2) comparison with nonhospitalist attendings; and (3) evaluation of trainee knowledge, skills, or attitudes. An abstraction form was developed based on the Best Evidence Medical Education protocol. Each citation meeting inclusion criteria was extracted by 3 reviewers.
Results:
We identified 711 articles and 7062 meeting abstracts. Of these, 32 articles were retrieved, and 6 met all criteria, whereas 10 abstracts were retrieved, and 3 met all criteria. Two citations were abstracted twice to compare hospitalists with both nonhospitalist general internists, and specialists. Two citations described pediatric hospitalists, whereas the rest included internal medicine hospi‐talists. Three citations surveyed residents, 4 surveyed medical students, and 3 surveyed both. All citations measured trainee attitudes. The most common measures surveyed included trainees' overall satisfaction, satisfaction with teaching, and feedback ratings. In studies comparing hospitalists with nonhospitalist general internists and specialists, trainees were more satisfied with teaching and the overall experience with hospitalists, but ratings were high for both groups. One of 2 studies that distinguished nonhospitalist general internists from specialists showed that trainees preferred hospitalists in terms of overall satisfaction, teaching, and feedback but the other did not demonstrate a hospitalist advantage over general internists. No studies evaluated residents' or students' learning or performance based on attending type.
Conclusions:
The data suggest that trainees are generally more satisfied with inpatient education from hospitalists. However, comparisons of hospitalists to general internists have yielded mixed results, with some studies showing equivalent learner satisfaction. Whether the increased satisfaction with hospitalists translates to improved learning is unclear.
Author Disclosure:
P. Natarajan, none; S. Ranji, none; A. Auerbach, none; K. Hauer, none.