"What is the mechanism?": Cues, barriers, and opportunities to discuss foundational science during internal medicine rounds.
Med Teach
; 44(7): 765-771, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35132917
ABSTRACT
BACKGROUND:
Repeated application of foundational science (FS) during medical reasoning results in encapsulation of knowledge needed to develop clinical expertise. Despite proven benefit of educating learners using a FS framework to anchor clinical decision making, how FS is integrated on clinical rotations has not been well characterized. This study examines how and when FS discussion occurs on internal medicine teaching rounds. MATERIAL ANDMETHODS:
We performed a convergent mixed method study. Six internal medicine teams at a quaternary hospital were observed during rounds and team members interviewed. Transcripts were analyzed using thematic analysis. Descriptive statistics provided a summary of the observations.RESULTS:
Our study revealed that rounds used a teacher-centered model where FS knowledge was transmitted as pearls external to the clinical context. FS content arose primarily when the patient was complex. Barriers preventing FS discussion were lack of time and perceived lack of personal FS knowledge.CONCLUSION:
Our study describes scenarios that commonly elicit discussion of FS on inpatient medicine rounds highlighting a 'transmission' model of FS knowledge. We suggest a learner-centered model that engages students in the practice of integrating FS into clinical reasoning.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Visitas de Preceptoria
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article