Techniques and behaviors associated with exemplary inpatient general medicine teaching: an exploratory qualitative study
BACKGROUND
Clinician educators face numerous obstacles to their joint mission of facilitating high-quality learning while also delivering patient-centered care. Such challenges necessitate increased attention to the work of exemplary clinician educators, their respective teaching approaches, and the experiences of their learners.
OBJECTIVE
To describe techniques and behaviors utilized by clinician educators to facilitate excellent teaching during inpatient general medicine rounds.
DESIGN
An exploratory qualitative study of inpatient teaching conducted from 2014 to 2015.
SETTING
Inpatient general medicine wards in 11 US hospitals, including university-affiliated hospitals and Veterans Affairs medical centers.
PARTICIPANTS
Participants included 12 exemplary clinician educators, 57 of their current learners, and 26 of their former learners.
MEASUREMENTS
In-depth, semi-structured interviews of exemplary clinician educators, focus group discussions with their current and former learners, and direct observations of clinical teaching during inpatient rounds.
RESULTS
Interview data, focus group data, and observational field notes were coded and categorized into broad, overlapping themes. Each theme elucidated a series of actions, behaviors, and approaches that exemplary clinician educators consistently demonstrated during inpatient rounds: (1) they fostered positive relationships with all team members by building rapport, which in turn created a safe learning environment; (2) they facilitated patient-centered teaching points, modeled excellent clinical exam and communication techniques, and treated patients as partners in their care; and (3) they engaged in coaching and collaboration through facilitation of discussion, effective questioning strategies, and differentiation of learning among team members with varied experience levels.
CONCLUSION
This study identified consistent techniques and behaviors of excellent teaching during inpatient general medicine rounds. Journal of Hospital Medicine 2017;12:503-509. © 2017 Society of Hospital Medicine
© 2017 Society of Hospital Medicine
Disclosure
Dr. Saint is on a medical advisory board of Doximity, a new social networking site for physicians, and receives an honorarium. He is also on the scientific advisory board of Jvion, a healthcare technology company. Drs. Houchens, Harrod, Moody, and Ms. Fowler have no conflicts of interest.
