The Nature of Excellent Clinicians at an Academic Health Science Center

Abstract

A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.

Promoting Resident Autonomy During Family-Centered Rounds: A Qualitative Study of Resident, Hospitalist, and Subspecialty Physicians

“…The facilitators used a focus group moderator guide with the resident focus groups, and a semistructured interview guide with the attending physicians, which was developed by the research team based on existing literature on teaching during bedside rounds. 14,15,20,21 The guides were piloted with residents and attending physicians not enrolled in the study prior to use in the study. In addition to asking a variety of general teaching-related questions, we asked residents about the challenges of balancing resident autonomy with patient care (eg, ''Can you describe ways in which your attendings have effectively managed this balance?'')…”

How evidence from observing attending physicians links to a competency-based framework

“…The medical education literature has previously identified humanism and relationality (e.g. people skills) as important performance tools in the everyday practice of the clinician, teacher and leader …”

The Importance of Situational Awareness

“…The primary facilitator used separate nurse and family member moderator guides to explore the perspectives of the participants, while the other facilitator observed, followed up on participants' responses, and sought clarification and elaboration when necessary. The research team developed the moderator guides drawing on the existing literature, 14,18,19,[27][28][29] and piloted them with nurses and family members not enrolled in the study; the pilot participants did not recommend any changes. (See Supplemental Digital Appendix 1 and Supplemental Digital Appendix 2 for moderator guides, http://links.lww.…”