Background: Hospitalists are increasingly being asked to provide a significant proportion of the teaching on the inpatient ward service. The increasing teaching load has led to an expansion of the cohort of faculty members serving in this role, leading to teaching assignments for inexperienced educators. Peer observation of teaching (PoT) has previously been reported as a creative initiative to increase inexperienced teaching hospitalists’ exposure to effective teaching styles, however the focus in these programs has been on those who are predominately in clinician educator roles.
Purpose: To describe a novel PoT program situated in a large urban academic medical center designed for inexperienced hospitalist educators who are primarily employed as direct care hospitalists.
Description: Eight hospitalists were selected to participate in a 6 month PoT pilot. Participants had highly variable clinical and teaching experience and responsibilities. The hospitalists were divided into two groups of four physicians and were subsequently scheduled to complete a 30-minute observation of each of the other three physicians in their group over a 6 month period (January 2019-June 2019). The focus of the observation was on teaching rounds, which is composed of one hospitalist, one resident, two interns and 1-3 medical students. The rounds take place weekdays from 8:30-10:30am. Prior to the first observation, all participants received a program overview document by email and then attended a 30-minute meeting to discuss goals and logistics for the program and questions were answered. In keeping with a previously published model (1), rather than focus on delivering and receiving feedback, the emphasis of the program was on observation and reflection so participants could develop new teaching strategies. Observation dates for the pairs were scheduled centrally by the hospitalist office and reminders were sent out via text message in the days prior to the scheduled observation.
Conclusions: We successfully developed and implemented a PoT pilot program that served as a faculty development initiative focused on primarily direct care hospitalists and inexperienced clinical teachers. 95.8% (23/24) of the scheduled observations were completed. By report, observations lasted, on average, 30 minutes. 87% of the observations were completed while the observing hospitalist was scheduled to work clinically (65% on a direct care service, 22% on the medicine consult (teaching) service. The remainder of the observations occurred during administrative (non-clinical) time. Based on data obtained from both a pre- and post-pilot survey of participants with a 100% response rate, the time commitment of 30 minutes per observation was considered manageable, despite a busy clinical schedule. Additionally, while participants indicated being ‘nervous’ about being observed in the pre-intervention survey, no participants indicated any negative interactions or anxiety after going through the observation process.