Background: On the 2016 ACGME survey, our Internal Medicine residents indicated that our service vs. education rating was at 47% compared to the national average of 69%. Purpose: To decrease resident physician workload to improve our education on inpatient wards, decrease the amount of non-physician level tasks to improve efficiency and to improve patient communication. [...]

Background: Duty hour restrictions for resident physicians have led to the ubiquity of night float systems. While this change has positively influenced well-being and supervision, limited studies indicate a negative impact of night float rotations on resident education. Nocturnists have been identified as a key resource for improving the educational value of night float rotations, [...]

Background: Attending evaluations by medical students have many implications including promotion, teaching opportunities, job satisfaction and reputation both for individuals and for groups. In addition to teaching on traditional ward teams with housestaff and students, hospitalists are more commonly teaching in an apprenticeship model, where an attending, often carrying a full census, directly supervises and [...]

Background: Time with learners is a finite resource on the teaching wards. As patient care becomes progressively more complex and clinical demands increase, it can be easy for teaching to get deferred to the next day, which is inevitably just as busy as the day before. Limitation in time due to clinical demands is a [...]

Background: Resident work rounds (RWR) serve as the venue for team-based patient interaction, subsequent patient care planning, and education through didactics and observation. However, the expectations of RWR are unclear; do residents continue to see patients and is teaching still expected? If not, what barriers exist? Few studies examining RWR structure have been done however [...]

Background: Point of care ultrasound (POCUS) significantly augments physical exam and improves medical management, and many medical schools across the United States are implementing undergraduate POCUS curricula. As a result, internal medicine (IM) residency programs have incoming interns with varying levels of POCUS knowledge and skill. We administered a needs assessment questionnaire to incoming interns [...]

Background: Early development of clinical reasoning and problem-solving competencies are essential in generating individualized, outcome-based, and cost-effective patient care plans (Nat Acad Press 2015). However, few medical schools and residency programs have an explicit curriculum in clinical reasoning (Graber et al., 2012). A recent survey of internal medicine clerkship directors found medical students receive limited [...]

Background: Lumbar puncture and paracentesis are core competencies in internal medicine, but residents frequently report discomfort performing these procedures unsupervised. Simulation-based training (SBT) has previously been shown to improve resident performance of lumbar punctures on patients, but outcomes after paracentesis SBT have only been assessed on simulators. We hypothesized that SBT would improve internal medicine [...]

Background: An effective patient safety and quality improvement (QI) curriculum is imperative for graduate medical education (GME) training programs. Yet many health systems are lacking pedagogical training in these methods. Learning often takes the form of group project work, yet projects may not reflect institutional priorities, duplicate ongoing efforts, or remain unfinished after allotted time [...]

Background: High quality discharges improve patients’ health outcomes and experience and are a vital component of resident education. Our internal medicine residency program has had challenges in sustaining our efforts to improve discharge planning and in providing resident feedback on the process. Furthermore, despite access to “big data”, many residency programs struggle to find meaningful [...]