University of Colorado School of Medicine, Aurora, Colorado (V.P.).
Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.K., L.M., C.C., K.D., N.M., S.M., M.B.).
Ann Intern Med. 2023 Nov;176(11):1526-1535. doi: 10.7326/M23-1497. Epub 2023 Nov 14.
Clinical growth is outpacing the growth of traditional educational opportunities at academic medical centers (AMCs).
To understand the impact of clinical growth on the educational mission for academic hospitalists.
Qualitative study using semistructured interviews that were analyzed using a mixed inductive and deductive method at the semantic level.
Large AMCs across the United States that experienced clinical growth in the past 5 years.
Division heads, section heads, and other hospital medicine (HM) leaders who oversaw and guided academic and clinical efforts of HM programs.
Themes and subthemes.
From September 2021 to January 2022, HM leaders from 17 AMCs participated in the interviews, and 3 key themes emerged. First, AMCs' disproportionate clinical growth highlighted the tension between clinical and educational missions. This included a mismatch in supply and demand for traditional teaching time, competing priorities, and clinical growth being seen as both an opportunity and a threat. Second, amid the shifting landscape of high clinical demands and evolving educational opportunities, hospitalists still strongly prefer traditional teaching. To address this mismatch, HM groups have had to alter recruitment strategies and create innovative solutions to help build academic careers. Third, participants noted a need to reimagine the role and identity of an academic hospitalist, emphasizing tailored career pathways and educational roles spanning well beyond traditional house staff teaching teams.
The study focused on large AMCs.
Although HM groups have implemented many creative strategies to address clinical growth and keep education front and center, challenges remain, particularly heavy clinical workloads and a continued dilution of traditional teaching opportunities.
Society of Hospital Medicine Student Scholar Grant.
临床业务的发展速度超过了学术医疗中心（AMC）传统教育机会的发展速度。
了解临床业务的发展对医院医师学术使命的影响。
采用半结构化访谈的定性研究，在语义层面上使用混合归纳和演绎方法进行分析。
美国多家大型 AMC，在过去 5 年内经历了临床业务的增长。
负责监督和指导医院医学项目学术和临床工作的科室主任、部门主任和其他医院医学（HM）领导。
主题和子主题。
从 2021 年 9 月到 2022 年 1 月，17 家 AMC 的 HM 领导者参加了访谈，出现了 3 个关键主题。首先，AMC 不成比例的临床增长凸显了临床和教育使命之间的紧张关系。这包括传统教学时间的供需不匹配、优先事项相互竞争，以及临床业务的增长既被视为机会，也被视为威胁。其次，在高临床需求和不断变化的教育机会背景下，医院医师仍然强烈倾向于传统教学。为了解决这种不匹配，HM 团队不得不改变招聘策略，并创造创新解决方案，以帮助建立学术职业。第三，参与者指出需要重新构想学术医院医师的角色和身份，强调量身定制的职业发展道路和教育角色，远远超出传统住院医师教学团队。
该研究侧重于大型 AMC。
尽管 HM 团队已经实施了许多创造性策略来应对临床业务的增长，并将教育放在首位，但仍面临挑战，特别是繁重的临床工作量和传统教学机会的持续减少。
医院医学学会学生学者资助。
