Outpatient Exam Room Presentations in Resident Continuity Clinics: a Qualitative Report
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ORIGINAL RESEARCH
Outpatient Exam Room Presentations in Resident Continuity Clinics: a Qualitative Report Rachel Vanderberg 1
&
Tanya Nikiforova 1 & Megan Hamm 1,2 & Carla Spagnoletti 1 & Melissa McNeil 1
Accepted: 1 October 2020 # International Association of Medical Science Educators 2020
Abstract Introduction Outpatient exam room presentations (OERPs) in resident continuity clinics could address several current challenges in graduate medical education including increasing patient satisfaction, enhancing patient-centered care, and operationalizing competency-based education through direct observation. The authors’ aim of this study was to explore the positive and negative aspects of OERPs as a precepting model in resident continuity clinics and to develop a list of best practices for medical educators to utilize when conducting OERPs. Materials and Methods The authors defined an OERP as a case presentation and subsequent discussion taking place inside the exam room with the attending physician, resident physician, and patient present. Following a 1-month pilot period of conducting OERPs in internal medicine resident continuity clinics, the authors conducted individual phone interviews and focus groups with internal medicine attendings and residents, respectively. The authors analyzed transcripts using thematic analysis and the constant comparative method. Sixteen attendings participated in individual phone interviews and four resident focus groups averaged five participants per group. Results Four main topics emerged: (1) effect of OERPs on patient care, (2) effect of OERPs on medical education, (3) barriers to OERPs, and (4) OERP best practices. Conclusion Participants noted both positive and negative effects of OERPs on patient care and medical education. Best practices suggested to maximize these benefits and minimize drawbacks included targeting OERPs to certain types of clinical encounters and employing strategies to preserve the resident physician-patient relationship and resident autonomy. Keywords Exam room presentation . Bedside rounds . Resident continuity clinics
Introduction Since the 1980s, patient presentations have moved away from the bedside to the hallway or conference room [1–5]. Factors Prior Presentation Poster Presentation. Society of General Internal Medicine Annual Meeting, Denver, CO, 2018 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40670-020-01092-y) contains supplementary material, which is available to authorized users. * Rachel Vanderberg [email protected] 1
Division of General Internal Medicine, UPMC Montefiore Hospital, University of Pittsburgh School of Medicine, 200 Lothrop St., Pittsburgh, PA 15213, USA
2
Qualitative, Evaluation and Stakeholder Engagement (Qual EASE) Research Core, University of Pittsburgh Center for Research on Health Care Data Center, Pittsburgh, PA, USA
implicated in the shift away from the bedside include increased administrative burden [2], shorter hospital stays [2, 6], insufficient time for fa
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