Educator Expectations

EDUCATIONAL GUIDELINES FOR ATTENDING PHYSICIANS IN INTERNAL MEDICINE

Educational Goals:

The primary educational goals of the attending physician on the inpatient service include:

  1. Directing care for all staff patients on the service.
  2. Directing teaching activities at the level of the house officer, student, and, where appropriate, fellow.
  3. Serving as a role model for housestaff, students, and fellows with regard to patient care and interaction with all components of the health care team.
  4. Supervising and evaluating housestaff, students, and fellows.

Responsibilities for Teaching Students and Housestaff:

1.  The attending physician will conduct teaching rounds with the housestaff for approximately one hour twice weekly and will conduct teaching rounds with the students for one hour three times weekly.  These sessions are to be reserved for teaching; they are not to be used to sign charts or conduct other ward business.  Such sessions are to be intensely patient oriented.  They will usually involve presentation and discussion of specific patients or common clinical problems.  They should include frequent sessions at the bedside wherein the attending can demonstrate physical findings and techniques of history taking.  Exercises that demonstrate how the attending physician approaches the evaluation and management of a specific patient are particularly valuable.  These sessions should not be used for lectures regarding the attending physician's research interest.  If the press of ward business intrudes on scheduled times, these sessions should be rescheduled.  

2.  A typical schedule is outlined in the Appendix:

3. Attending physicians will conduct teaching rounds in their own styles.  All attendings should make sure that their students and residents can collect and present clinical information in an accurate, efficient, and logical manner.  The Department would like to emphasize physical diagnostic skill during teaching rounds with students.

4.  Except under the most unusual circumstances, there are no restrictions on which patients can be used for teaching exercises. 

5.The attending physician should review with the residents their responsibility for student teaching and determine if the responsibilities are being met.  If they are not, then attendings need to stress the importance of doing so.  The attending should stress to the housestaff the importance of timely completion of student evaluations for grading.

6.   The attending physician should meet briefly with each student individually to provide feedback at the midpoint of the rotation.  One should provide both positive and negative evaluations.  Even the superstars want advice about how they might improve.  Give feedback promptly.  The students need to know what you think early.  They should not be surprised when they review the evaluations with the clerkship director at the end of the rotation.  Provide a more formal       feedback sessions at the end of the rotation.  You may want to use your last student teaching session for this purpose.  Remember that each student will see your evaluation form at exit interviews.  

7.Fill out the students' evaluation forms carefully and promptly.  We will pursue you until you fill out the forms and return them to us.  Students will see these forms at the end of the Clerkship but only after they have filled out their evaluations of their experiences.  The grade for the inpatient service component of the Internal Medicine Clerkship is based 50% on attending, and 50% on housestaff, evaluations. Students are evaluated with regard to medical knowledge, clinical skills (including ability to perform a history and physical examination), and interpersonal skills as applied in the clinical setting. The Internal Medicine clerkship grade is calculated from grades on the inpatient service, AIM, and the Subject Examination in Internal Medicine of the USMLE, Step 2, each weighted at 33%.

8.  Provide feedback to the housestaff regularly.  Fill out housestaff evaluation forms promptly and carefully.   

9.  Attending physicians may also utilize Praise and Early Concern Cards to provide feedback on students.  These forms are filed electronically and anonymously.  The website for accessing these cards is http://www.med-ed.virginia.edu/listen/facultycomment.cfm 

10. Questions can be addressed to Dr. Amy Tucker, Joy Hilton (3-6158) or Dr. Donowitz (4-1918). 

 

Appendix
Typical Schedule

Monday:
0700-0800:  Students and interns preround on their patients
0815-0900:  Student morning report Monday, Wednesday, Thursday and Friday
   On other services, students and housestaff round on all patients on service
0800-0900:  Residents attend morning report, students and housestaff conduct ward business
0900-1100:  Students and housestaff meet with attending for presentation of new patients and discussion of progress on old patients.  If the number of admissions is large or there are problems requiring prolonged discussion, this session may last longer than two hours.
1200-1300:  Residents conference

Tuesday:
0700-0800:  Students and interns preround on their patients
0800-0900:  Medical Grand Rounds
0900-1100:  Students and housestaff meet with attending for presentation of new patients and discussion of progress on old patients
1200-1300:  Residents conference
1300-1400:  (Approximate) Attending meets with students for teaching rounds

Wednesday:
0700-0800:  Students and interns preround on their patients
0815-0900:  Student morning report
0900-1100:  Students and housestaff meet with attending for presentation of new patients and discussion of progress on old patients
1100-1200:  Departmental morbidity and mortality conference
12:00-1300: lunch
1300-1400:  (Approximate) Attending meets with students for teaching rounds

Thursday:
0700-0800:  Students and interns preround on their patients
0815-0900:  Student morning report
0900-1100:  Students and housestaff meet with attending for presentation of new patients and discussion of progress on old patients
1200-1300:  Residents conference
1300-1400:  (Approximate) Attending meets with students for teaching rounds

Friday:
0700-0800:  Students and interns preround on their patients
0815-0900:  Student morning report
0900-1100:  Students and housestaff meet with attending for presentation of new patients and discussion of progress on old patients
1200-1300:  Residents conference
1300-1400:  (Approximate) Attending meets with students for teaching rounds

Saturday:
0700-0800:  Students and housestaff preround on their patients
0800-0930:  Attending rounds: present cases, visit bedside of new patients, card flip
0930 - ----:   Attending sees own patients and writes notes; no formal teaching sessions.

Sunday:
Scheduled individually with the ward team.  This schedule will depend on the number of admissions during the previous 24 hours.

The above schedule is modified by the presence twice weekly of Radiology Rounds, at which the attending physician should be present.