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Contextual Influences of Trainee Characteristics and Daily Workload on Trainee Learning Preferences.

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Trainees prioritize different teaching domains during inpatient medicine rounds based on their training level and daily workload. Senior residents and high-workload days emphasize team management, while students focus on the teaching process.

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Area of Science:

  • Medical Education
  • Inpatient Medicine
  • Clinical Teaching

Background:

  • Successful inpatient medicine attending rounds require defined teaching domains: Role Modeling, Learning Environment, Teaching Process, and Team Management.
  • Trainee characteristics and workload may influence the prioritization of these essential teaching domains.

Purpose of the Study:

  • To investigate how trainee characteristics and daily workload fluctuations affect the prioritization of key teaching domains during inpatient medicine attending rounds.
  • To determine if attending physicians should tailor rounds based on trainee needs and daily pressures.

Main Methods:

  • Prospective observational study over 6 months across university, VA, and county general medicine inpatient wards.
  • Daily assessment tool used by student and resident trainees to report prioritized teaching domain, training level, call-cycle day, patient census, and team size.
  • Pearson's chi-square analysis, adjusted for clustering, examined associations between trainee/workload factors and prioritized domains.

Main Results:

  • Students prioritized the Teaching Process, while senior residents prioritized Team Management (P < 0.001).
  • The Teaching Process was the most prioritized domain overall (P = 0.005).
  • Team Management was prioritized on post-call days and high patient census days (P < 0.001).

Conclusions:

  • Trainee level and workload significantly influence the perceived importance of different teaching domains during inpatient rounds.
  • Attending physicians can optimize teaching by adapting rounds to address trainee priorities, especially during demanding workdays.
  • High-workload days are opportunities to demonstrate efficient patient care and effective team management skills.