Related Experiment Video
Updated: Feb 15, 2026

Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
Service and Education: The Association Between Workload, Patient Complexity, and Teaching on Internal Medicine
Temple A Ratcliffe1,2, Meghan A Crabtree3, Raymond F Palmer4
1University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA. ratcliffe@uthscsa.edu.
Background:
Attending rounds remain the primary venue for formal teaching and learning at academic medical centers. Little is known about the effect of increasing clinical demands on teaching during attending rounds.
Objective:
To explore the relationships among teaching time, teaching topics, clinical workload, and patient complexity variables.
Design:
Observational study of medicine teaching teams from September 2008 through August 2014. Teams at two large teaching hospitals associated with a single medical school were observed for periods of 2 to 4 weeks.
Participants:
Twelve medicine teaching teams consisting of one attending, one second- or third-year resident, two to three interns, and two to three medical students.
Main Measures:
The study examined relationships between patient complexity (comorbidities, complications) and clinical workload variables (census, turnover) with educational measures. Teams were clustered based on clinical workload and patient complexity. Educational measures of interest were time spent teaching and number of teaching topics. Data were analyzed both at the daily observation level and across a given patient's admission.
Key Results:
We observed 12 teams, 1994 discussions (approximately 373 h of rounds) of 563 patients over 244 observation days. Teams clustered into three groups: low patient complexity/high clinical workload, average patient complexity/low clinical workload, and high patient complexity/high clinical workload. Modest associations for team, patient complexity, and clinical workload variables were noted with total time spent teaching (9.1% of the variance in time spent teaching during a patient's admission; F[8,549] = 6.90, p < 0.001) and number of teaching topics (16% of the variance in the total number of teaching topics during a patient's admission; F[8,548] = 14.18, p < 0.001).
Conclusions:
Clinical workload and patient complexity characteristics among teams were only modestly associated with total teaching time and teaching topics.
More Related Videos
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
07:49Automated Deployment of an Internet Protocol Telephony Service on Unmanned Aerial Vehicles Using Network Functions Virtualization
Published on: November 26, 2019
Related Concept Videos
Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
Preventive Healthcare Services
Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis
It is critical to determine the patient's learning needs during the assessment. Determination of learning needs compounds data...
Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
Internal Receptors