The Inpatient Apprenticeship

1Aurora Sinai Medical Center, Milwaukee, WI
2Aurora Sinai Medical Center, Milwaukee, WI
3Aurora Sinai Medical Center, Milwaukee, WI

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

Abstract number: 107


We have implemented an inpatient “apprenticeship” for all PGY1 IM residents. We hypothesize this rotation will expedite the development of core competencies as related to care of hospitalized patients by having a one‐on‐one experience with our hospitalist faculty.


The competencies we hope to achieve are improvement in: (1) patient‐centered care; (2) clinical skills — case presentations, cardiopulmonary exam, x‐ray, and EKG interpretation; and (3) documentation.


We worked closely with the hospitalist faculty and residents to: (1) develop goals and objectives for this new rotation, (2) define learning activities to fulfill the goals and objectives, and (3) develop assessment tools to assess resident learning and skill acquisition. PGY1 residents are assigned an inpatient rotation working one on one with a hospitalist. There is an initial assessment of physical exam skills, patient interview skills, and self‐assessment of the core competencies. Based on this initial evaluation the curriculum is modified to best serve the skill level of the resident. The curriculum has 3 components. First is independent learning modules. Modules contain selected readings and multimedia resources. Once completed the resident is evaluated to assess competence. Second is simulation. Sessions focus on cardiopulmonary exam skills and interview techniques. And the third component is direct observation of patient encounters. Faculty members ensure that all encounters incorporate the principles of patient‐centered care. Encounters may vary from focused system exams to complete H&Ps. Residents receive immediate verbal feedback and formal written evaluation after each encounter. Patient satisfaction surveys are completed for each encounter. Residents complete formal write‐ups that are reviewed by faculty and a hospital coder using current documentation guidelines.


We hypothesized that the experience of having all PGY1 IM residents complete an intense one‐on‐one educational experience early in their residency training might provide a stronger foundation on which to build their skills as internists. Through the use of the assessment tools developed for this rotation, our preliminary data showed improved acquisition of skills in the areas of patient‐centered interviewing, clinical exam, and documentation. Patient satisfaction surveys have been uniformly very good. To date, all but 1 resident has achieved competence in all areas. The overall feedback from the residents has been very positive.

Author Disclosure:

J. Jordan, none; M. Gennis, none; C. Mildenberg, none.

To cite this abstract:

Jordan J, Gennis M, Mildenberg C. The Inpatient Apprenticeship. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 107. Journal of Hospital Medicine. 2008; 3 (suppl 1). Accessed March 29, 2020.

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