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The Hospitalist Huddle: a 1-Year Experience of Teaching Hospital Medicine Utilizing the Concept of Peer Teaching in Medical Education

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The Hospitalist Huddle: a 1-Year Experience of Teaching Hospital Medicine Utilizing the Concept of Peer Teaching in Medical Education Journal name: Advances in Medical Education and Practice Article Designation: ORIGINAL RESEARCH Year: 2017 Volume: 8 Advances in Medical Education and Practice Dovepress Running head verso: Elhassan Running head recto: The Hospitalist Huddle open access to scientific and medical research DOI: http://dx.doi.org/10.2147/AMEP.S149450 Open Access Full Text Article ORIGINAL RESEARCH The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education Mohammed Elhassan Background: The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical Department of Internal Medicine, Division of Hospital Medicine, UCSF/ education of postgraduate residents and medical students. Little is known about the effectiveness Fresno Center for Medical Education of peer-to-peer teaching in internal medicine residency training programs and how the medical and Research, Fresno, CA, USA residents perceive its educational value in learning Hospital Medicine. Materials and methods: The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A For personal use only. survey disseminated at the end of the first year of its implementation examined the residents’ Video abstract perception of the educational value of this new teaching activity. Results: Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environ- ment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. Conclusion: The survey results support the notion that teaching and learning with flat hier- archies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents’ satisfaction. Point your SmartPhone at the code above. If you have a Keywords: graduate medical education, peer-to-peer teaching, teaching Hospital Medicine, QR code reader the video abstract will appear. Or use: medical residents’ education Advances in Medical Education and Practice downloaded from https://www.dovepress.com/ by 137.108.70.13 on 14-Jan-2020 http://youtu.be/gAbYS8u7Nik Introduction The term “hospitalist” was first coined by Drs Wachter and Goldman in their paper which discussed the evolving role of general internal medicine physicians who specialized in caring for patients admitted to hospitals and other health care facili- ties.1 Since then, Hospital Medicine in the USA has been one of the fastest growing Correspondence: Mohammed Elhassan 2 Department of Internal Medicine, fields in internal medicine. It is now a career choice for a substantial proportion of Division of Hospital Medicine, UCSF/ graduating internal medicine residents.3 A subset of hospitalists, known as academic Fresno Center for Medical Education and hospitalists, are largely involved in medical education. They supervise internal medi- Research, 155 N Fresno St, Fresno, CA 93701, USA cine residents and medical students during their rotations in general medical wards, Tel +1 559 499 6500 high dependency units, and, sometimes, intensive care units. In fact, teaching and Fax +1 559 499 6501 Email [email protected] research are important aspects of the Hospital Medicine movement, and the Society submit your manuscript | www.dovepress.com Advances in Medical Education and Practice 2017:8 785–789 785 Dovepress © 2017 Elhassan. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work http://dx.doi.org/10.2147/AMEP.S149450 you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Powered by TCPDF (www.tcpdf.org) 1 / 1 Elhassan Dovepress of Hospital Medicine emphasized this notion in its definition has educational value as per their judgment, and is related of a hospitalist.4 Therefore, academic hospitalists should to their daily practice in medical wards. All team members make all efforts to create ideas that enhance their learners’ who are available during the meeting time are required to educational experience during this important rotation of attend. The presenting resident leads the discussion, asks their residency training. and answers questions as required, with at least one faculty Peer-to-peer teaching is one promising approach that hospitalist present to serve as a facilitator. At the end of the has been shown to enhance learning and foster leadership 2016–2017 academic year (after 1 year of implementation), skills in medical education.5 However, little is known about an anonymous electronic survey was sent to all residents to its effectiveness in internal medicine residency training pro- obtain feedback about their perception of the educational grams and how the medical residents perceive its educational value of this novel educational practice. value in learning Hospital Medicine. This article describes the implementation of a novel hospitalist-supervised peer-to- Results peer teaching intervention in an internal medicine residency Twenty-two residents (N=22) responded to the survey (eleven program and examines the learning outcomes reported by were interns, seven were PGY-2s, and four were PGY-3s) with participating residents. This new teaching activity was named a response fraction of 35%. Most residents (56%) attended the Hospitalist Huddle. three or four sessions throughout the academic year, eight residents (36%) attended one or two, and two residents were Materials and methods able to attend five or more sessions. Examples of the topics The Division of Hospital Medicine inaugurated the Hos- that were discussed include: inpatient management of seizures, pitalist Huddle at the beginning of 2016–2017 academic a diagnostic challenge of a case with jaundice, causes and year in a large academic safety-net community hospital in management of acute upper gastrointestinal bleeding, radiation Central California, USA. It is a 30-minute, weekly activity oncology for internists, and others. Of all the residents who at which time the second- or third-year postgraduate medical responded to the survey, 87% mentioned that they were either For personal use only. resident (the PGY-2 or PGY-3, respectively) who leads one “satisfied” (64%) or “very satisfied” (23%) with the Huddle of the three teaching services rotating in general medical overall as an “educational experience” and that it was either wards in our facility is assigned to teach and discuss a topic “very useful” or “probably useful” (Figure 1). related to Hospital Medicine with the rest of the residents, The Huddle was created to take place every Thursday interns, and medical students. Each team, supervised by one afternoon (between 1:15 and 1:45 PM) as there is no other academic hospitalist, has one PGY-2 or PGY-3 resident, at teaching activity for residents on that day, and the afternoon least two interns and, on many occasions, one or two medical gives residents enough time to finish their post-rounding students. The presenting PGY-2 or PGY-3 has the freedom to orders and to make sure they have already had their lunch. choose any topic as long as it is related to Hospital Medicine, The team assigned to present the Huddle is the team in which 5. Very satisfied; I think it is very useful Advances in Medical Education and Practice downloaded from https://www.dovepress.com/ by 137.108.70.13 on 14-Jan-2020 4. Satisfied; I think it is probably useful 3. Not sure 2. Dissatisfied; I think it is probably not useful 1. Very dissatisfied; I do not think it useful at all 0 2468101214 Figure 1 The number of residents who responded to the question: “Overall, how would you rate your educational experience in the Huddle?” 786 submit your manuscript | www.dovepress.com Advances in Medical Education and Practice 2017:8 Dovepress Powered by TCPDF (www.tcpdf.org) 1 / 1 Dovepress The Hospitalist Huddle the leading resident has that Thursday as a pre-call day (usu- skills more”, most residents (68%) selected “probably yes” ally this is the least busy day). Nineteen residents (86%) and three residents (14%) selected “definitely yes”. They mentioned that this timing schedule is either “extremely were also asked whether they agreed that the Huddle “helps reasonable” or “somewhat reasonable”. No resident thought interns learn and understand acute and Hospital Medicine that the timing is “unreasonable” or suggested an alternative better”, and 13 residents (59%) said “probably yes” and five schedule. As far as the duration of the Huddle is concerned, residents (23%) said “definitely yes”. They were also asked which is about 30 minutes, 19 residents (86%) agreed this whether they agreed that the Huddle “gives residents useful duration of time is “reasonable”. clinical pearls about how to manage patients in the general The presenting resident was given the freedom to decide medical wards rotation”, and similar results were obtained on their Hospital Medicine topic that they would like to teach with most residents (64%) picking “probably yes” and five and also on the delivery method.
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