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The Qualities and Skills of Exemplary Pediatric Hospitalist Educators: A Qualitative Study. Fromme HB, Bhansali P, Singhal G, Yudkowsky R, Humphrey H, Harris I. Academic Medicine 2010;85:1905-1913.

Reviewed by Melissa Held

What was the study question?
Pediatric hospitalists have had an increasingly large role in the education of medical students and residents in the inpatient setting. This study sought to describe the teaching qualities and skills demonstrated by exemplary pediatric hospitalists. The goal was to elicit from hospitalists, residents and medical students what traits were felt to be most important in teaching in order to develop curricula or other interventions to enhance medical education.

How was the study done?
This was a prospective qualitative study performed at three academic institutions of different size and geography. At each site, chief residents and residency program directors were asked to identify the top pediatric hospitalists in their programs based on learner evaluations and feedback. Each of the identified hospitalists was interviewed with a semi-structured format. Pediatric residents and medical students who had recently worked with each of the identified hospitalists participated in focus groups to discuss their experience working with these faculty. Data was analyzed using the constant comparative method.

What were the results?
All six invited hospitalists participated in the study. Four domains were identified: teaching skills, personal qualities, patient care skills, and role modeling. Some traits were identified for "exemplary hospitalists" while others were for "ideal hospitalists." Certain qualities and skills identified confirmed other studies, yet several new themes emerged from this study.

Theme 1: Teaching skills - This area consisted of the most comments. Comments included finding teachable moments, teaching points within the context of the patient or situation, stimulation of learning and problem-solving, and how hospitalists help learners "think through the process" were noted.

Theme 2: Personal qualities- Hospitalists noted their own ability to gracefully accept feedback, reflect on their experiences, and being able to say "I don't know." Medical students noted that these faculty provided a "supportive environment" and were "encouraging." Residents noted hospitalists' approachability and professionalism.

Theme 3: Patient care skills - Although a smaller domain in terms of comments, learners noted hospitalists' knowledge acquisition and ability to access evidence-based literature as well as patient advocacy skills and system knowledge.

Theme 4: Role modeling - Although highly relevant to all other domains, this was given its own domain to emphasize its importance in the study findings.

What are the implications of these findings?
Although teaching skills, patient care skills and personal qualities were previously mentioned in other studies as being important to the exemplary hospitalist educator, this study noted role modeling as a unique quality. This was identified by participants as having a strong relationship with all domains. Medical education programs need to address this by incorporating development of this skill into curricula but also by emphasizing its importance in the education of learners. Pediatric hospitalists have the opportunity to have a large impact on the education of residents and students. (SLB)

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