Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Nashville

Poster Presentation:


MEDICAL STUDENTS' EXPERIENCES WITH ROTATING PEDIATRIC HOSPITALISTS

Authors:

L. Barry Seltz, MD, MD, Children's Hospital  Colorado and University of Colorado School of Medicine, Aurora, CO, Alison  Montgomery, MD, Children's Hospital Colorado and University of Colorado School  of Medicine, Aurora, CO, Lindsey Lane, MD, Children's Hospital Colorado and  University of Colorado School of Medicine, Aurora, CO, Jennifer Soep, MD,  Children's Hospital Colorado and University of Colorado School of Medicine,  Aurora, CO, Janice Hanson, MD, Children's Hospital Colorado and University of  Colorado School of Medicine, Aurora, CO


Background: Pediatric hospitalists, transiently working on inpatient wards, participate in a rotational approach to medical education. Effects on trainees from working with changing faculty are unknown. Our study's objective was to explore medical students’ experiences working with rotating pediatric hospitalists.
Methods: Focus groups (n=3) and individual interviews (n=5) were performed with a purposeful sample (n=27) of 3rd/4th year medical students from general pediatric inpatient teams. Semi-structured interview questions focused on teaching, feedback, evaluation, and professional growth. Data were transcribed verbatim. Applying grounded theory, codes were developed using an emergent approach. At least 2 investigators coded each transcript; differences were resolved by consensus.  Thematic analysis was performed until theoretical saturation.
Results: The inpatient experience for students has many interrelating pieces. Themes included learning environment, continuity, student resilience, opportunity to progress, evaluation, and physician growth. In the learning environment, students valued exposure to varying teaching/patient care styles. Opportunities to show clinical skills during a week with the attending physician were limited. Senior resident continuity was critical to student function. Students found adjusting to differing expectations of a new hospitalist stressful and an important skill. The inability to build on assessment and feedback was felt to negatively impact student evaluations and inhibit their growth into a physician.
Conclusion: Benefits to working with rotating hospitalists include exposure to varying teaching and patient care styles. Student opportunities to show clinical skills and improvement were limited. Devising practices that capitalize on positive effects of rotating hospitalists, while moderating challenges, will optimize the professional growth of students into physicians.