A study conducted by Emory University School of Medicine researchers shows that hospitalists and general internists are highly effective teachers on the hospital wards. The study, published in the January issue of the Journal of General Internal Medicine, is the largest such study published and the first to examine the influence of hospitalists on medical student education.
Hospitalists are physicians whose primary professional focus is the care of hospitalized patients. A hospitalist program was established at Grady Memorial Hospital in 1998 by Mark V. Williams, MD, associate professor in the Department of Medicine, Division of General Medicine, at Emory University School of Medicine, and was the first of its kind at a public teaching hospital. Since that time, Emory's Hospital Medicine Unit has grown to include another 35 hospitalists at six hospitals in the Atlanta area.
The study was authored by Sunil Kripalani, MD, MSc, Assistant Professor in Emory's Department of Medicine, Division of General Medicine, and supported in part by a grant from the Emory Medical Care Foundation.
"With the rapid growth of Hospital Medicine and the increasing demand from academic medical centers to have hospitalists serve as teaching faculty in the hospital, we felt it was important to compare the effectiveness of their teaching skills on the general medicine wards," said Dr. Kripalani. "We were pleased to discover that medical students and residents considered hospitalists and general medicine faculty to be highly effective teachers in this setting."
Over a one-year period, 423 medical students and residents evaluated 63attending physicians using a validated instrument, the Clinical Tutor Evaluation. They also provided open-ended written comments. Qualitative analysis of written remarks revealed that trainees valued faculty who were enthusiastic teachers, practiced evidence-based medicine, were involved inpatient care, and developed a good rapport with patients and other team members. These characteristics were most often noted for hospitalists and general medicine attending physicians and may explain the higher ratings they received on the quantitative Clinical Tutor Evaluation. Also included in the comparison were sub-specialists from a variety of disciplines who supervised general medicine ward teams.
"Hospitalists are typically more available during the day to provide patient care and supervise the ward team," said Dr. Kripalani. "This increased contact provides an important opportunity to teach and mentor medical students."
The hospitalist program at Grady is currently led by Neil Winawer, MD, assistant professor in the Department of Medicine, Division of General Medicine at Emory University School of Medicine and involves 13 faculty members. The Division of General Medicine, directed by William T. Branch, Jr., MD, performs the majority of the medical student and resident teaching at Grady.