Kulkarni Vivek T, Salgado Sanjay M, Pelletier Stephen R, Shields Helen M
Division of Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Hospitalist Service, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Adv Med Educ Pract. 2019 Jan 21;10:15-21. doi: 10.2147/AMEP.S181153. eCollection 2019.
The specific teaching methods used by internal medicine residents on walk rounds are unknown.
We conducted a prospective mixed-methods study on inpatient medical services at a single academic medical center from September 2016 to January 2017. Participants were internal medicine residents (postgraduate year [PGY]-1, PGY-2, and PGY-3) and attending physicians. Teachers were PGY-2 and PGY-3 residents, and learners were PGY-1 residents. Residents' teaching on rounds was observed and characterized according to resident demographics, specific teaching methods, and length of time. Participants completed a survey with Likert scale and free-text questions.
Among 136 surveys across 28 separate teaching encounters, we noted that PGY-3 residents' teaching was rated significantly better than PGY-2 residents' teaching. Teaching lasting >1 minute was rated significantly better than teaching lasting <1 minute. Free-text responses emphasized the value of immediate clinical relevance, citing published evidence, conciseness, clarity, and pertinence to the patient. Our findings may help guide internal medicine residents aiming to teach better on rounds and inform further research into specific resident teaching methods.
内科住院医师在床边查房时所采用的具体教学方法尚不清楚。
1）实时描述内科住院医师在查房时所采用的具体教学方法，2）确定查房时住院医师成功教学的特点。
2016年9月至2017年1月，我们在一家学术医疗中心的住院医疗服务部门进行了一项前瞻性混合方法研究。参与者为内科住院医师（第1年、第2年和第3年）和主治医师。教师为第2年和第3年住院医师，学习者为第1年住院医师。根据住院医师的人口统计学特征、具体教学方法和时间长度，对住院医师的查房教学进行观察和描述。参与者完成了一项包含李克特量表和自由文本问题的调查。
在28次单独教学过程中的136份调查问卷中，我们发现第3年住院医师的教学评分显著高于第2年住院医师。持续时间>1分钟的教学评分显著高于持续时间<1分钟的教学。自由文本回复强调了即时临床相关性、引用已发表证据、简洁性、清晰度以及与患者相关性的价值。我们的研究结果可能有助于指导旨在在查房时进行更好教学的内科住院医师，并为进一步研究具体的住院医师教学方法提供信息。
