Volume 19, Number 1, 8-15, DOI: 10.1111/j.1525-1497.2004.20907.x

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Hospitalists as teachers
How do they compare to subspecialty and general medicine faculty?

Sunil Kripalani, Allison C. Pope, Kimberly Rask, Kimberly Hunt, Daniel D. Dressler, William T. Branch, Rebecca Zhang and Mark V. Williams

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Abstract

OBJECTIVE: To compare evaluations of teaching effectiveness among hospitalist, general medicine, and subspecialist attendings on general medicine wards.
DESIGN: Cross-sectional.
SETTING: A large, inner-city, public teaching hospital.
PARTICIPANTS: A total of 423 medical students and house staff evaluating 63 attending physicians.
MEASUREMENTS AND MAIN RESULTS: We measured teaching effectiveness with the McGill Clinical Tutor Evaluation (CTE), a validated 25-item survey, and reviewed additional written comments. The response rate was 81%. On a 150-point composite measure, hospitalists’ mean score (134.5 [95% confidence interval (CI), 130.2 to 138.8]) exceeded that of subspecialists (126.3 [95% CI, 120.4 to 132.1]), P=.03. General medicine attendings (135.0 [95% CI, 131.2 to 138.8]) were also rated higher than subspecialists, P=.01. Physicians who graduated from medical school in the 1990s received higher scores (136.0 [95% CI, 133.0 to 139.1]) than did more distant graduates (129.1 [95% CI, 125.1 to 133.1]), P=.006. These trends persisted after adjusting for covariates, but only year of graduation remained statistically significant, P=.05. Qualitative analysis of written remarks revealed that trainees valued faculty who were enthusiastic teachers, practiced evidence-based medicine, were involved in patient care, and developed a good rapport with patients and other team members. These characteristics were most often noted for hospitalist and general medicine attendings.
CONCLUSIONS: On general medicine wards, medical students and residents considered hospitalists and general medicine attendings to be more effective teachers than subspecialists. This effect may be related to the preferred faculty members exhibiting specific characteristics and behaviors highly valued by trainees, such as enthusiasm for teaching and use of evidence-based medicine.

Key words  hospitalist - internist - medical education - subspecialist

Dr. Kripalani presented a portion of this work’s findings at the National Association of Inpatient Physicians Annual Meeting, March 2001; at the Society of General Internal Medicine Annual Meeting, May 2000; and at the American College of Physicians Georgia Regional Meeting, May 2000.

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