Guidelines for Teaching Attendings
General Medicine Wards 2007-2008

Assignment of Teams

You will receive information from the Department of Medicine, Office of Education regarding your team assignment one to two weeks prior to the beginning of the month.  This information will include the names and pager numbers of the resident, interns and acting intern on the team, along with the names of the third year students.  There will be a designated conference room assigned to your team with this information.

You will be responsible for completing evaluations on all of the residents and students listed.

Duration and Frequency of Teaching Sessions

Unless otherwise indicated, responsibilities as Teaching Attending will begin on the first business day of the month, and end on the last business day of the month.

The ACGME guidelines in Medicine require that Teaching Attending rounds take place for at least 4.5 hours each week.  Therefore, we ask all Attendings to meet with the teams 3-5 days per week.  One day of the week, usually Tuesday, can be set aside to meet with the third year students if so desired.  The usual time for rounds is either 10:30 a.m.- noon or 9-10:30 a.m. (for work/management rounds).

Special Considerations: 

·    The guidelines also require that bedside teaching rounds be a part of the teaching attending rounds.  These must include demonstration of interviewing and physical exam techniques.  Therefore, it is highly suggested that two to three days of the week, attending rounds be made while the team is on management rounds on their patients. This gives the attending an opportunity to observe the teams’ interactions with patients and each other, the leadership style of the resident, and to evaluate the competencies of patient care, medical knowledge, communication skills and professionalism.

·     The Mini-CEX, or observed clinical exercise, can be done on bedside rounds.  (Please see the section on the Mini-CEX.)

Teaching Content

The residents and students have all received goals and objectives for the General Medical Wards.  These are enclosed in this handbook for your review.  At the beginning of each month, you should review your expectations of the team for the month.  Each day will present new opportunities for learning and teaching.

Suggestions:

·     Ask the team members about their individual goals for the month.

·     Change the format of rounds to maintain the interest level of the team, including yourself.  Speaking about one specific case can be interspersed with management rounds, literature reviews, and presentation of specific topics by the teams.  Radiology rounds are also very fun and helpful to the team.

·     Consider having a “follow-up day” during which the team members, including yourself, present the answers to the clinical questions that come up on rounds during the previous week.

Duty Hour Considerations

All residents will be adhering to the Duty Hours regulations.  This means that for you, the teaching attending, you may be asked on certain days to round with the team as they do management rounds, so that the intern can more efficiently see the patients on his or her service in time for early sign outs.

Suggestions for Scheduling

The team’s call schedule is set months in advance; please plan on making management rounds on the post call day, and another day of that week, such as Thursday after Grand Rounds.  Please try to do management rounds on the remainder of the teams’ patients when you meet with them at 10:30, especially on the post call day.

Evaluation

Enclosed in this packet at the Goals and Objectives as well as Medical Knowledge objectives that have been given to the residents.  Please review these to familiarize yourself with the competency-based approach.  As you can see, many of the competencies can be taught and evaluated by the teaching attending.  The processes of self-study and self-appraisal by the resident are also very important.  Both are essential for accomplishing many of the goals set forth for the resident on the medical wards.

You will be asked to give formative feedback to the residents and to the students.  We are asking you to do this at the mid-month mark, as well as at the end of the evaluation.  This should include areas that they did well in and areas for improvement. 

Suggestions for Effective Evaluation

·    Give feedback in a timely manner.

·    Give feedback often and remember to include the positives:  The residents are working long hours, and have challenging patients:  It is nice to hear that they are doing well, and progressing nicely!

·    Give the formative feedback individually in a confidential manner.  Your designated conference room is an ideal location.

·    Use the enclosed “Praise Cards” or “Early Warning notes.”  If you don’t feel comfortable discussing an area of concern, the Program Director is available and will be able to assist. 

PLEASE REMEMBER TO COMPLETE YOUR EVALUATIONS AT THE END OF THE MONTH!

Thank you for your participation in this core educational venue, and enjoy the month!