Attending Perspectives on Medical Student Learning in Resident-Led Inpatient Teams

Internal Medicine (IM) clerkships are a core clinical experience in medical school where third-year students (MS3s) learn and apply their medical knowledge to patient care. How students approach learning from direct patient care is shaped by their team environment, notably their attending physicians. Less, however, is known about how attending physicians conceptualize their instructional role in supporting student learning within resident-led inpatient teams. We examined how IM attendings understand how MS3s learn on the wards and how attendings conceptualize their role in supporting that learning within resident-led inpatient teams.

The authors conducted 20 semistructured interviews of IM attendings who supervised MS3s on inpatient teams in 2024. Participants were asked about how students learn from patient care and their role in supporting this learning. Data were analyzed iteratively through qualitative description using inductive thematic analysis.

Twenty attendings participated in 30-minute semistructured interviews, resulting in thematic sufficiency. Three major themes emerged from the interviews: attendings must navigate their teaching role within resident-led teams, competing system and evaluative demands shape student engagement in clinical learning, and integration of clinical experience and structured autonomy enhance medical knowledge learning. Attendings held varying interpretations of their role in supporting student learning and described how students required guidance in navigating competing expectations. This ranged from providing direct student teaching to coaching residents in their instructional skills.

Attendings described differing instructional approaches within resident-led inpatient teams. Understanding these conceptualizations may help identify opportunities to align instructional expectations and support student learning from direct patient care.