Student Satisfaction with Physical Examination Instruction on Attending‐Only Hospitalist Services Versus Traditional Ward Teams

1University of California, San Francisco, San Francisco, CA

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 38

Background:

Attending‐only hospitalist services have been developed at academic centers in response in part to resident duty‐hour restrictions. The efficacy of these clinical services as teaching venues for medical students has not been assessed.

Purpose:

The purpose of the study was to evaluate student satisfaction with physical examination skills instruction during a medicine clerkship on an attending‐only hospitalist service versus with a traditional ward team.

Description:

In 2006‐2007, third‐year students on the internal medicine clerkship at a tertiary‐care teaching hospital received physical examination instruction with the ward team attending during usual team activities. They also participated in a 1‐hour physical exam session with a separate hospitalist attending at an affiliated hospital without house staff. At the end of the clerkship, using a 5‐point Likert scale survey (from 1 = strongly disagree to 5 = strongly agree), students rated their satisfaction with the quality of physical examination instruction from the ward team attending and from the hospitalist on the attending‐only service.

Conclusions:

Of the 29 students who have rotated onto the clerkship to date, 22 participated in the one‐time physical exam session on the attending‐only service; survey response was 100%. Students reported no difference in overall exam skills instruction between hospitalists on the attending‐only service and their ward attendings (3.6 vs. 3.9, P = .22), and they reported equal self‐confidence in examination skills in both settings (3.4 vs. 3.7, P = .13). Students perceived the attending‐only service as a safer learning environment (4.3 vs. 3.7, P = .02). There was no significant difference in instructors' level of enthusiasm or distraction, amount of time spent on questions and skills practice, or amount of direct observation of students' skills. However, students evaluated traditional ward attendings higher as role models during patient interactions (3.6 vs. 4.2, P = .01). Feedback from the attending was rated lower than other survey items on both services (2.8 vs. 3.3, P = .17).

Based on these preliminary results, attending‐only services are effective venues for physical examination instruction for medical students. Students perceived teaching encounters on these services as a safer learning environment than traditional wards, perhaps because they were not evaluated by the hospitalist on the attending‐only service. Students likely rated their ward attendings as better role models because they shared longitudinal relationships. However, students rated the overall physical examination instruction comparably in the 2 settings. Given the growing prevalence of attending‐only services at academic institutions, utilizing these services to enhance bedside teaching may help to address challenges of medical student education on traditional ward teams.

Author Disclosure:

C. Lee, None; C. J. Lai, None; A. Green, None; K. E. Hauer, None.

To cite this abstract:

Lee C, Lai C, Green A, Hauer K. Student Satisfaction with Physical Examination Instruction on Attending‐Only Hospitalist Services Versus Traditional Ward Teams. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 38. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/student-satisfaction-with-physical-examination-instruction-on-attendingonly-hospitalist-services-versus-traditional-ward-teams/. Accessed May 26, 2019.

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