TEAMwork! An Innovative Hospital Medicine Teaching Program to Enhance Learners' Educational Experience

Workplace-based learning and assessment are dependent on frequent observations, feedback, teaching, and evaluations. Yet high physician workload and multiple learners limit these efforts. A local needs assessment demonstrated insufficient direct observations, small-group teaching, and high-quality evaluations for learners. In response, the authors developed and implemented Teaching Excellence Among Medical providers (TEAM), a teaching program to enhance the educational experience of learners in pediatric hospital medicine (PHM).

The TEAM program, grounded in a self-regulated learning framework, launched in 2019. The University of Colorado Department of Pediatrics provided salary support. TEAM hospitalists completed professional development for teaching and feedback skills. During their TEAM shifts, they observed, provided feedback, completed evaluations, and led teaching sessions for learners on PHM rotations. The program's impact was evaluated by using an electronic work tracking form and surveying learners, attending hospitalists, and TEAM hospitalists, leading to iterative program improvements.

Over an 18-month period, TEAM hospitalists completed 1,573 direct observations, 265 teaching sessions attended by 1,921 learners, and more than 497 learner evaluations. Survey results showed that 95% of learners indicated TEAM was "very effective" or "somewhat effective" in helping achieve individualized learning goals, and a similar percentage "strongly agreed" or "agreed" that TEAM hospitalists were effective educators. Eighty-four percent of attending hospitalist survey respondents reported TEAM contributed "very much" or "somewhat" to learner education. Attending hospitalists particularly appreciated TEAM's ability to focus on learners identified as struggling, while TEAM hospitalists rated observation of rounds and small-group teaching sessions as the most valuable TEAM activities.

The TEAM program employed concepts of self-regulated learning to enhance education in PHM through direct observation, feedback, written evaluations, and teaching efforts. This program can mitigate many challenges facing attending physicians and can serve as a model for other institutions. Next steps include evaluation of higher-level learning outcomes.