Literature DB >> 17330996

Disruptions and satisfaction in internal medicine resident continuity clinic differ between inpatient and outpatient rotations.

Stephen M Salerno1, Paul M Faestel, Timothy Mulligan, Michael J Rosenblum.   

Abstract

BACKGROUND: Little is known about whether assignment to simultaneous inpatient and outpatient clinical duties causes disruptions during internal medicine resident continuity clinic and impacts trainee satisfaction.
PURPOSE: Our purpose was to determine whether dual inpatient and continuity clinic responsibilities impact resident stress and document the number, type, and immediacy of interruptions in continuity clinics.
METHODS: Methods included a prospective 2-residency survey of 70 internal medicine residents performing 240 half-day continuity clinic sessions.
RESULTS: More than half (52%) of trainees on inpatient rotations felt pressured to return to their ward duties. Half (50%) of residents thought clinic increased work hours, and the majority (70%) did not think continuity clinic detracted from their education on inpatient or elective rotations. Disturbances were more likely to occur on inpatient rotations (odds ratio 4.52, 95% confidence interval = 2.298.92) than on outpatient rotations. The time required to address an interruption was 3.9 +/- 4.51 min. Residents thought many (46%) problems addressed during clinic could have waited until clinic completion.
CONCLUSIONS: Residents on inpatient rotations who were commonly interrupted in clinic felt pressured to return to ward duties and unable to focus on their clinic patients. Internal medicine faculty should modify curriculum to minimize the interference of other duties in resident clinics.

Entities:  

Mesh:

Year:  2007        PMID: 17330996     DOI: 10.1080/10401330709336620

Source DB:  PubMed          Journal:  Teach Learn Med        ISSN: 1040-1334            Impact factor:   2.414


  13 in total

1.  A strategy to reduce interruptions at hospital morning report.

Authors:  Mark L Wieland; Laura L Loertscher; Darlene R Nelson; Jason H Szostek; Robert D Ficalora
Journal:  J Grad Med Educ       Date:  2010-03

2.  Determinants of Patient Satisfaction in Internal Medicine Resident Continuity Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative.

Authors:  Maureen D Francis; Eric Warm; Katherine A Julian; Michael Rosenblum; Kris Thomas; Sean Drake; Keri Lyn Gwisdalla; Michael Langan; Christopher Nabors; Anne Pereira; Amy Smith; David Sweet; Andrew Varney; Mark L Francis
Journal:  J Grad Med Educ       Date:  2014-09

3.  Factors Affecting Resident Satisfaction in Continuity Clinic-a Systematic Review.

Authors:  J Stepczynski; S R Holt; M S Ellman; D Tobin; Benjamin R Doolittle
Journal:  J Gen Intern Med       Date:  2018-05-07       Impact factor: 5.128

4.  Ambulatory-based education in internal medicine: current organization and implications for transformation. Results of a national survey of resident continuity clinic directors.

Authors:  Mohan Nadkarni; Siddharta Reddy; Carol K Bates; Blair Fosburgh; Stewart Babbott; Eric Holmboe
Journal:  J Gen Intern Med       Date:  2010-07-14       Impact factor: 5.128

5.  Clinic design, key practice metrics, and resident satisfaction in internal medicine continuity clinics: findings of the educational innovations project ambulatory collaborative.

Authors:  Maureen D Francis; Kris Thomas; Michael Langan; Amy Smith; Sean Drake; Keri Lyn Gwisdalla; Ronald R Jones; Katherine A Julian; Christopher Nabors; Anne Pereira; Michael Rosenblum; Andrew Varney; Eric Warm; Melchor Ortiz
Journal:  J Grad Med Educ       Date:  2014-06

6.  Effect of number of clinics and panel size on patient continuity for medical residents.

Authors:  Maureen D Francis; Whitney E Zahnd; Andrew Varney; Steven L Scaife; Mark L Francis
Journal:  J Grad Med Educ       Date:  2009-12

7.  An evaluation of internal medicine residency continuity clinic redesign to a 50/50 outpatient-inpatient model.

Authors:  Mark L Wieland; Andrew J Halvorsen; Rajeev Chaudhry; Darcy A Reed; Furman S McDonald; Kris G Thomas
Journal:  J Gen Intern Med       Date:  2013-08       Impact factor: 5.128

8.  Alternative approaches to ambulatory training: internal medicine residents' and program directors' perspectives.

Authors:  Kris G Thomas; Colin P West; Carol Popkave; Lisa M Bellini; Steven E Weinberger; Joseph C Kolars; Jennifer R Kogan
Journal:  J Gen Intern Med       Date:  2009-05-28       Impact factor: 5.128

9.  Resident Inbox Task Completion Is Improved with a Single Electronic Health Record (EHR) System.

Authors:  Anand D Jagannath; Christopher Nabors; William Southern; Sheira Schlair; Rosemarie Conigliaro
Journal:  J Gen Intern Med       Date:  2020-03-05       Impact factor: 5.128

10.  Factors Associated with a Career in Primary Care Medicine: Continuity Clinic Experience Matters.

Authors:  Irina Kryzhanovskaya; Beth E Cohen; R Jeffrey Kohlwes
Journal:  J Gen Intern Med       Date:  2021-02-23       Impact factor: 5.128

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