The Role of the Attending Physician

Greganti, M. Andrew; Drossman, Douglas A.; Rogers, John F.

doi:10.1001/archinte.1982.00340170054011

Cited by 18 publications

(4 citation statements)

References 3 publications

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“…Nevertheless, clinical teachers, as an extensive literature attests, continue to play a key role in residents' education. Not only do clinical teachers teach much of the content and skills residents learn, they also model the attitudes, behaviours and values residents acquire (Engel 1982; Gjerde & Coble 1982; Greganti et al 1982; Physicians for the Twenty‐First Century 1984; Ficklin et al 1988; Knudson et al 1989).…”

Section: Factors Influencing Residents' Educational Experiencesmentioning

confidence: 99%

Residents' perceptions of their teachers: facilitative behaviour and the learning value of rotations

et al. 1993

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Despite changes in modern medicine the role of the clinical teacher remains central to medical residents' education and rotations continue to be their dominant educational context. Residents have strong positive feelings for clinical teachers who are perceived as interested in teaching and for those rotations that provide a balance of educational opportunities and patient care responsibilities. Research in residency education has focused on teacher behaviours used to teach medical residents clinical information or patient care skills but has neglected teacher behaviours used to facilitate effective learning relationships with residents. To explore the impact of clinical teachers' use of facilitative behaviours on residents' educational experience, we use concepts stemming from the psychologist Carl Rogers' work previously shown to be associated with positive learning outcomesempathy, unconditional positive regard, and congruence. These constructs are measured by the use of the four scales of the Barrett-Lennard Relationship Inventory (BLRI) -level of regard, unconditionality of regard, congruence and empathy. Our study measures the correlation between residents' perceptions of clinical teachers' use of facilitative behaviours and residents' evaluation of the learning value of rotations. Thirty-three residents completed the BLRI on a different clinical teacher for each of six monthly rotations. A total of 158 surveys were returned. There were strong positive correlations between three of the BLRI variables and residents' perception of the learning value of rotations. Potential uses of these findings are discussed.

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Section: Factors Influencing Residents' Educational Experiencesmentioning

confidence: 99%

Residents' perceptions of their teachers: facilitative behaviour and the learning value of rotations

et al. 1993

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“…The final proper diagnosis looks like a goal with a pathway including deep understanding [5]. Introducing the status of new patients in educational sessions result in a thoughtful challenge of critical thinking and decision-making [6,7]. Studies have shown that proper and systematic presentation of cases lead to reduced patient`s length of stay in the hospital and costs [8].…”

Section: Introductionmentioning

confidence: 99%

The Necessity of Proper Case Presentation in Educational Sessions

Yazdani¹,

Arab²,

Noghabaei³

et al. 2014

nova-jmbs

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Morning report sessions are for sure the best known case-based educational meetings in the history of medical education. This study is aimed to evaluate the proper case presentation in such sessions. Seventy three morning report sessions in different wards of five main hospitals of a type-1 university were evaluated regarding the number of the cases, duration of each presentation, availability of 24-hour admission lists and seven quality indices of proper case presentation. The Mean number of the cases was 3 and the mean duration of case presentation was 4 minutes. The Total score of quality indices was 82%, while the Total score of the availability of admission list of cases was 50%. In the present study, the different aspects of proper case presentation were revealed in the studied university. Keywords: Education, Medical; Patient Care; Students IntroductionThe basic purpose of case presentation during morning report sessions is teaching skills in medicine in a practice-based way. In this way, students improve their competencies and in a framework of learning objectives [1][2][3][4]. As the case is presented and summarized, differential diagnosis is explored; and the plan for further evaluation and management is discussed. The plan is to expand the educational opportunity of learning from the case that comes with each patient presentation. There are wide differences among patients' diagnosis at the hospital admission time. Properly conducting such a process will help students to learn more about it. The final proper diagnosis looks like a goal with a pathway including deep understanding [5]. Introducing the status of new patients in educational sessions result in a thoughtful challenge of critical thinking and decision-making [6,7]. Studies have shown that proper and systematic presentation of cases lead to reduced patient`s length of stay in the hospital and costs [8].Regarding the duration of a case presentation, the results of a study revealed that most faculty members and students at different levels believed that the ideal time is 5 minutes [9]. Proper case presentation is defined as determining and flagging the main issues for each patient, which might be taught. Summarizing a case could be canalized in ten points directing to proper differential diagnosis. These points may be applied to subgroups including chief complaint, differential diagnosis, the chief complaint of the patient, the description of the disease resulting in the list of the probable diagnosis [10]. This study is to assess the different aspects of a proper case presentation in case-based sessions. These include duration of case presentation and seven indices of complete case presentation.

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“…Primarily, the morning report follows educational goals . The educational goals vary widely, but they generally include the fostering of clinical decision‐making skills, promotion of problem‐solving skills and planning of patient management . Morning report sessions have been considered as social events, as well as educational programmes that address ethical and economic issues…”

Section: Introductionmentioning

confidence: 99%

Effects of morning report case presentation on length of stay and hospitalisation costs

et al. 2013

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CONTEXT The primary goal of discussing patient cases during the morning report is to teach appropriate clinical decision making. In addition, the selection of the best diagnostic strategy and application of evidence-based patient care are important. Reducing hospital costs is fundamental to controlling inflation in health care costs, especially in university hospitals that are subject to budget constraints in developing countries. The goal of this study was to explore the effect of morning report case presentation on length of stay (LoS) and hospitalisation costs in a university teaching hospital.METHODS A total of 54 patients whose cases had been presented at morning report sessions in the department of internal medicine during a 3-month period (presented group) were selected and their medical records reviewed for data on final diagnosis, hospital LoS and detailed hospital costs. A control group of 104 patients, whose cases had not been presented, were selected on the basis that their final diagnoses matched with those of the presented group. In addition, the groups were matched for age, sex, occupation, comorbidities and insurance coverage. Final diagnoses were based on International Classification of Disease 10 (ICD-10) diagnostic code criteria. RESULTSThe mean AE standard deviation (SD) hospital LoS was 8.32 AE 4.11 days in the presented group and 10.46 AE 4.92 days in the control group (p = 0.045). Mean AE SD hospitalisation costs per patient were significantly lower in the presented group (US $553.43 AE 92.16) than the control group (US $1621.93 AE 353.14) (p = 0.004). Although costs for paraclinical services were similar, there were very significant reductions in costs for medications used during hospitalisation and bed-days (p = 0.002).CONCLUSIONS Discussing clinical aspects of patient cases in morning report sessions facilitates the management process and has a significant effect on LoS and hospitalisation costs in patients admitted to hospital.

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The Role of the Attending Physician

Cited by 18 publications

References 3 publications

Residents' perceptions of their teachers: facilitative behaviour and the learning value of rotations

Residents' perceptions of their teachers: facilitative behaviour and the learning value of rotations

The Necessity of Proper Case Presentation in Educational Sessions

Effects of morning report case presentation on length of stay and hospitalisation costs

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