The resident as teacher during work rounds.

Area of Science:

• Medical Education
• Internal Medicine Training
• Clinical Teaching Skills

Background:

• Residents play a crucial role in educating medical students and peers.
• Understanding resident teaching practices is essential for improving medical training.
• Inpatient work rounds offer a unique setting to observe resident-led teaching without direct faculty supervision.

Purpose of the Study:

• To examine the teaching behaviors of internal medicine residents during inpatient work rounds.
• To identify the most and least frequent methods residents use to educate trainees.
• To inform the development of targeted clinical teaching interventions for residents.

Main Methods:

• Observation of 14 first- and second-year internal medicine residents.
• Analysis of 158 patient case reviews during inpatient work rounds.
• Focus on resident-initiated teaching in the absence of attending faculty.

Main Results:

• Bedside teaching behaviors, such as modeling patient interaction and verifying clinical findings, were most frequent.
• Brief lectures were commonly used for teaching away from the bedside.
• Referring to literature, providing feedback, demonstrating skills, and asking questions were least observed teaching behaviors.

Conclusions:

• Resident teaching predominantly occurs at the bedside through direct patient care activities.
• Specific teaching methods, like literature review and feedback, require more emphasis in resident training.
• A structured course on clinical teaching was developed based on these findings to enhance resident educators' skills.