Training Residents in Hospital Medicine: The Hospitalist Elective National Survey

Ludwin, Steven; Harrison, James D.; Ranji, Sumant R; Sharpe, Bradley A.; Kneeland, Patrick

doi:10.12788/jhm.2952

Cited by 13 publications

(15 citation statements)

References 14 publications

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“…While duty hour restrictions have been shown to reduce burnout (Busireddy et al 2017), compressing the clinical care into fewer hours can limit opportunities for education. While direct patient care can be and certainly is educational, it is important that trainees observe their mentors working clinically to model their care for patients after them as they gain real-world experience (Ludwin et al 2018).…”

Section: The Seven Spiritual Work Of Mercy As a Framework To Preventmentioning

confidence: 99%

The Spiritual Works of Mercy as a Tool to Prevent Burnout in Medical Trainees

Shaniuk

2020

Linacre Q

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Burnout is highly prevalent among physicians and is associated with negative patient outcomes. Furthermore, medical training is a particularly vulnerable time as studies show that medical students, residents, and fellows experience burnout and emotional exhaustion at higher rates than both the general population and physicians in practice. Multiple recent studies have demonstrated the practice of religion and spirituality to be protective against burnout in trainees. Can Catholic academic physicians transfer these protective benefits of religion and spirituality to their trainees, who are at the highest risk, and who may or may not share their faith? An ancient Catholic tradition, the Seven Spiritual Works of Mercy, may hold the key. The Spiritual Works of Mercy are listed by the US Conference of Catholic Bishops as Counseling the Doubtful, Instructing the Ignorant, Admonishing the Sinner, Comforting the Sorrowful, Forgiving Injuries, Bearing Wrongs Patiently, and Praying for the Living and the Dead. Using this as a framework, examples of evidenced-based actions from the literature that have been shown to either prevent burnout or to improve the day-to-day experience of medical trainees were discussed. Examples include encouraging trainees to express doubts or to debrief after difficult and saddening cases. Academic physicians can provide instruction, feedback, or admonishment; demonstrate forgiveness of errors; and model the way in bearing wrongs patiently, all while uplifting their trainees in prayer. The Spiritual Works of Mercy can thus become a framework for academic physicians to uplift their trainees’ spirits and potentially prevent against burnout. Summary: Burnout is highly prevalent in medical students and in doctors during their residency or fellowship training, but multiple studies have shown regular practice of Religion and Spirituality to be protective against burnout. The Seven Spiritual Works of Mercy (Counsel the Doubtful, Instruct the Ignorant, Admonish the Sinner, Comfort the Sorrowful, Forgive All Injuries, Bear Wrongs Patiently and Pray for the Living and the Dead) provide a framework of powerful examples for teaching physicians, particularly Catholic teaching physicians, to uplift their students and potentially transfer this benefit to reduce their students’ risk for burnout.

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Section: The Seven Spiritual Work Of Mercy As a Framework To Preventmentioning

confidence: 99%

The Spiritual Works of Mercy as a Tool to Prevent Burnout in Medical Trainees

Shaniuk

2020

Linacre Q

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“…To address these barriers to success in non-clinical competencies, some institutions have implemented faculty development programs, which have led to improved work satisfaction and academic output [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics, satisfiers, development needs, and barriers to success for early-career academic hospitalists

et al. 2022

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Background Academic hospitalists engage in many non-clinical domains. Success in these domains requires support, mentorship, protected time, and networks. To address these non-clinical competencies, faculty development programs have been implemented. We aim to describe the demographics, job characteristics, satisfiers, and barriers to success of early-career academic hospitalists who attended the Academic Hospitalist Academic (AHA), a professional development conference from 2009 to 2019. Methods Survey responses from attendees were evaluated; statistical analyses and linear regression were performed for numerical responses and qualitative coding was performed for textual responses. Results A total of 965 hospitalists attended the AHA from 2009 to 2019. Of those, 812 (84%) completed the survey. The mean age of participants was 34 years and the mean time in hospitalist practice was 3.2 years. Most hospitalists were satisfied with their job, and teaching and clinical care were identified as the best parts of the job. The proportion of female hospitalists increased from 42.2% in 2009 to 60% in 2019 (p = 0.001). No other demographics or job characteristics significantly changed over the years. Lack of time and confidence in individual skills were the most common barriers identified in both bedside teaching and providing feedback, and providing constructive feedback was an additional challenge identified in giving feedback. Conclusions Though early-career hospitalists reported high levels of job satisfaction driven by teaching and clinical care, barriers to success include time constraints and confidence. Awareness of these factors of satisfaction and barriers to success can help shape faculty development curricula for early-career hospitalists.

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“…In our on-going multi-site collaborative study at ten academic institutions across the USA, the triagist or the admission point of contact was a faculty physician over 75% of the time. 16 With hospitalists now numbering over 50,000 (more than twice that of any IM sub-specialty) 17 and a growing number of programs offering hospitalist-focused clinical rotations, 18 we believe it is critical for IM residency programs to integrate triage training into their curricula. Triage responsibilities encompass many of the internal medicine end of training entrustable professional activities (EPAs) 19 such as: manage transitions of care, lead and work within interprofessional health care teams, and manage care of patients with acute complex diseases across multiple care settings.…”

Section: Introductionmentioning

confidence: 99%

Triaging Inpatient Admissions: an Opportunity for Resident Education

et al. 2019

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In the context of internal medicine, Btriage^is a newly popularized term that refers to constellation of activities related to determining the most appropriate disposition plans for patients, including assessing patients for admissions into the inpatient medicine service. The physician or Btriagist^plays a critical role in the transition of care from the outpatient to the inpatient settings, yet little literature exists addressing this particular transition. The importance of this set of responsibilities has evolved over time as health systems become increasingly complex to navigate for physicians and patients. With the emphasis on hospital efficiency metrics such as emergency department throughput and appropriateness of admissions, this type of systems-based thinking is a necessary skill for practicing contemporary inpatient medicine. We believe that triaging admissions is a critical transition in the care continuum and represents an entrustable professional activity that integrates skills across multiple Accreditation Council for Graduate Medical Education (ACGME) competencies that internal medicine residents must master. Specific curricular competencies that address the domains of provider, system, and patient will deliver a solid foundation to fill a gap in skills and knowledge for the triagist role in IM residency training.

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Training Residents in Hospital Medicine: The Hospitalist Elective National Survey

Cited by 13 publications

References 14 publications

The Spiritual Works of Mercy as a Tool to Prevent Burnout in Medical Trainees

The Spiritual Works of Mercy as a Tool to Prevent Burnout in Medical Trainees

Characteristics, satisfiers, development needs, and barriers to success for early-career academic hospitalists

Triaging Inpatient Admissions: an Opportunity for Resident Education

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