Resident Reflections on a New Community Hospital Rotation

1Hospitalist Medicine, Mount Auburn Hospital, Cambridge, MA
2General Internal Medicine, Boston University Medical Center, Boston, MA
3School of Education, Boston University, Boston, MA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 115

Background:

Every day, internal medicine (IM) house staff members work on the wards with hospitalist teachers and attendings. Increasing numbers are choosing careers in hospitalist medicine postresidency despite limited exposure to the full range of available hospitalist roles. Jobs in academic centers are very different from those in nonteaching community hospitals. New rotations can provide insight into these differences and perhaps lead to a better job fit.

Purpose:

(1) To describe a pilot hospitalist rotation at a non‐teaching community hospital. (2) To explore the opinions of IM residents on the structure and content of this new rotation. (3) To use resident feedback to revise the rotation and help to better plan for future rotations.

Description:

Our internal medicine residency program piloted a community hospital rotation for third‐year IM residents designed to incorporate systems‐based medicine (SBM) teaching into the experience. Rounds were supplemented with lectures on billing, hospital reimbursement, and risk management. Twelve residents participated in one‐on‐one exit interviews to provide feedback on the program. Open‐ended questions were asked about perceptions of the community hospital experience, hospitalist medicine, and overall feedback on the rotation. We analyzed the audiotaped responses using qualitative methodology to identify recurring themes. The aggregate feedback was then compiled for rotation revision.

Conclusions:

The composite interview data allowed insight into the residents' experiences during the rotation. Responses were categorized under either work environment or educational environment. The data revealed differences between the initial curricular objectives and the perceived reality. Residents reported less autonomy than during the university hospital wards and indistinct job roles. They expressed a strong desire for professional growth and to be challenged in their work. However, they still preferred structured daily didactics over an apprenticeship model with periodic teaching sessions. The sessions on SBM were well received but need to be expanded on. Residents have well defined roles as learners and care providers in the university hospital setting, which have to be redefined for new learning environments. Expectations and goals have to be clearly stated, both for the preceptors and the resident participants. Resident feedback is critical to the successful implementation of new curricula and is vital for ongoing revision.

Author Disclosure:

S. Page, none; S. Ramani, none; B. Fraser, none.

To cite this abstract:

Page S, Ramani S, Fraser B. Resident Reflections on a New Community Hospital Rotation. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 115. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/resident-reflections-on-a-new-community-hospital-rotation/. Accessed July 17, 2019.

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