Teaching the Teacher: Novel Faculty Development for VA Hospitalists.

Background: The US Department of Veterans Affairs (VA) is the largest educator of health professions trainees in the country, but the roles and responsibilities of the modern clinician educator are increasingly challenging and complex. Most VA academic hospitalists with access to professional and faculty development receive it through academic affiliates. Many VA hospitalists lack this option, and teaching within the VA is unique given its specific health system, clinical environments, and patient population. Observations: Teaching the Teacher is a facilitation-based educational series for inpatient hospitalists at VA medical centers that is tailored to self-reported needs and provides faculty development through the lens of VA medicine. The transition from in-person to synchronous virtual programming allowed for wider dissemination of the program, and to date, 10 VA hospitalist sections across the country have participated in the series. Conclusions: VA clinicians want and deserve dedicated training to optimize their confidence and skills in their roles as health professions educators. Teaching the Teacher is a pilot faculty development program that has met success based on its goal of meeting the specific needs of VA clinician educators in hospital medicine. It has the potential to serve as a model for clinical educator onboarding and to allow for the rapid spread of best teaching practices among clinical educators.

Interruptions to Attending Physician Rounds and Their Effect on Resident Education.

BACKGROUND: Daily attending rounds (AR) are a cornerstone of teaching and patient care in academic health centers. Interruptions in health care are common and can cause increased risk of errors, incomplete work, and decreased decision-making accuracy. Interruptions to AR may diminish a trainee's capacity to learn and retain information. OBJECTIVE: We characterized and quantified interruptions that occur during AR. METHODS: We used a mixed-methods design combining a prospective observational study with a qualitative study. AR were observed January to March 2020 to characterize interruptions, followed by semi-structured interviews with the observed physicians to elucidate the effect of interruptions on workflow and the educational value of rounds. RESULTS: There were 378 observed interruptions over the course of 30 AR sessions, averaging 12.6 (range 1-22, median 13) interruptions per rounding session. Bedside nursing staff was the most common source of interruptions (25%) and consultant recommendations was the most common topic of interruption (21%). Most interruptions occurred during patient presentations (76%), and the most common method of interaction was text message (24%). Most team members described negative effects of interruptions, including loss of focus and missing critical clinical information; some also reported that certain interruptions had positive effects on education and clinical care. Interns were more likely to report negative emotional reactions to interruptions. CONCLUSIONS: AR are frequently interrupted for non-urgent topics by a variety of methods and sources. Negative effects included loss of focus, missed information, and increased stress. Proactive communication, particularly between physicians and nurses, was suggested to reduce interruptions.