Review Green Open Access 2004

Hospitalists as Teachers: How Do They Compare to Subspecialty and General Medicine Faculty?

Journal of General Internal Medicine
Journal · Vol. 19 · Issue 1 · pp. 8-15
Abstract

OBJECTIVE: To compare evaluations of teaching effectiveness among hospitalist, general medicine, and subspecialist attendings on general medicine wards. DESIGN: Cross-sectional. SETTING: A large, inner-city, public teaching hospital. PARTICIPANTS: A total of 423 medical students and house staff evaluating 63 attending physicians. MEASUREMENTS AND MAIN RESULTS: We measured teaching effectiveness with the McGill Clinical Tutor Evaluation (CTE), a validated 25-item survey, and reviewed additional written comments. The response rate was 81%. On a 150-point composite measure, hospitalists' mean score (134.5 [95% confidence interval (CI), 130.2 to 138.8]) exceeded that of subspecialists (126.3 [95% CI, 120.4 to 132.1]), P = .03. General medicine attendings (135.0 [95% CI, 131.2 to 138.8]) were also rated higher than subspecialists, P = .01. Physicians who graduated from medical school in the 1990s received higher scores (136.0 [95% CI, 133.0 to 139.1]) than did more distant graduates (129.1 [95% CI, 125.1 to 133.1]), P = .006. These trends persisted after adjusting for covariates, but only year of graduation remained statistically significant, P = .05. Qualitative analysis of written remarks revealed that trainees valued faculty who were enthusiastic teachers, practiced evidence-based medicine, were involved in patient care, and developed a good rapport with patients and other team members. These characteristics were most often noted for hospitalist and general medicine attendings. CONCLUSIONS: On general medicine wards, medical students and residents considered hospitalists and general medicine attendings to be more effective teachers than subspecialists. This effect may be related to the preferred faculty members exhibiting specific characteristics and behaviors highly valued by trainees, such as enthusiasm for teaching and use of evidence-based medicine.

Keywords

Author Keywords

medical education Hospitalist Internist Subspecialist

Index Keywords

Teaching adult clinical competence cross-sectional study female human male medical education Cross-Sectional Studies Humans Internship and Residency Article education controlled study United States physician medical student review Students, Medical human experiment medical school normal human comparative study qualitative analysis teacher resident professional practice standard clinical education confidence interval Faculty, Medical Clinical Clerkship Medicine medical practice teaching hospital public hospital medical staff Physician-Patient Relations evidence based medicine Evidence-Based Medicine Georgia doctor patient relation Specialties, Medical Hospitals, Public Hospitalists Hospitals, Municipal
Author Affiliations
School of Medicine, Emory University School of Medicine, Atlanta, GA, United States, Division of General Medicine, Emory University School of Medicine, Atlanta, GA, United States
Family Practice Residency Program, MaineHealth Maine Medical Center, Portland, ME, United States
School of Medicine, Emory University School of Medicine, Atlanta, GA, United States, Rollins School of Public Health, Atlanta, GA, United States
Georgia Hospital Association, Atlanta, GA, United States
School of Medicine, Emory University School of Medicine, Atlanta, GA, United States
Rollins School of Public Health, Atlanta, GA, United States
Funding & Acknowledgements
Emory Medical Care Foundation, EMCF
This work was supported in part by a grant from the Emory Medical Care Foundation.
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