Improving teaching on an inpatient pediatrics service: a retrospective analysis of a program changeReport as inadecuate




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BMC Medical Education

, 12:92

Approaches to teaching and learning

Abstract

BackgroundThe traditional role of the faculty inpatient attending providing clinical care and effectively teaching residents and medical students is threatened by increasing documentation requirements, pressures to increase clinical productivity, and insufficient funding available for medical education. In order to sustain and improve clinical education on a general pediatric inpatient service, we instituted a comprehensive program change. Our program consisted of creating detailed job descriptions, setting clear expectations, and providing salary support for faculty inpatient attending physicians serving in clinical and educational roles. This study was aimed at assessing the impact of this program change on the learners’ perceptions of their faculty attending physicians and learners’ experiences on the inpatient rotations.

MethodsWe analyzed resident and medical student electronic evaluations of both clinical and teaching faculty attending physician characteristics, as well as resident evaluations of an inpatient rotation experience. We compared the proportions of -superior- ratings versus all other ratings prior to the educational intervention 2005–2006, baseline with the two subsequent years post intervention 2006–2007, year 1; 2007–2008, year 2. We also compared medical student scores on a comprehensive National Board of Medical Examiners clinical subject examination pre and post intervention.

ResultsWhen compared to the baseline year, pediatric residents were more likely to rate as superior the quality of didactic teaching OR=1.7 1.0-2.8 year 1; OR=2.0 1.1-3.5 year 2 and attendings’ appeal as a role model OR=1.9 1.1-3.3 year 2. Residents were also more likely to rate as superior the quality of feedback and evaluation they received from the attending OR=2.1 1.2-3.7 year 1; OR=3.9 2.2-7.1 year 2. Similar improvements were also noted in medical student evaluations of faculty attendings. Most notably, medical students were significantly more likely to rate feedback on their data gathering and physical examination skills as superior OR=4.2 2.0-8.6 year 1; OR=6.4 3.0-13.6 year 2.

ConclusionsA comprehensive program which includes clear role descriptions along with faculty expectations, as well as salary support for faculty in clinical and educational roles, can improve resident and medical student experiences on a general pediatric inpatient service. The authors provide sufficient detail to replicate this program to other settings.

KeywordsMedical education Teaching attending Clinical skills  Download fulltext PDF



Author: Michael A Barone - Robert A Dudas - Rosalyn W Stewart - Julia A McMillan - George J Dover - Janet R Serwint

Source: https://link.springer.com/







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