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Teaching during consultation: factors affecting the resident-fellow teaching interaction
Eli M Miloslavsky1, Jakob I McSparron2, Jeremy B Richards2
1Division of Rheumatology, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Medical Education
|June 17, 2015
Summary
Residents and fellows desire teaching interactions during consultations. Barriers exist, but many are changeable, offering opportunities to improve medical education on hospital wards.
Area of Science:
- Medical Education
- Qualitative Research
- Internal Medicine Training
Background:
- Subspecialty consultations offer valuable learning opportunities for residents.
- Barriers can hinder effective educational exchanges between fellows and residents.
Purpose of the Study:
- To identify barriers and facilitators of resident-fellow teaching interactions.
- To explore opportunities for enhancing teaching and learning during consultations.
Main Methods:
- Four focus groups conducted with internal medicine residents and subspecialty fellows.
- Qualitative framework approach used for transcript analysis, informed by activity theory.
Main Results:
- Barriers identified in personal (e.g., perceived resistance, willingness to engage) and systems-based (e.g., consult process, workload) domains.
- Barriers impacted initial and follow-up stages of consultations differently.
Conclusions:
- Residents and fellows are motivated to engage in teaching during consultations.
- Modifiable barriers exist within the hospital environment, suggesting potential for interventions to improve learning.
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