ABSTRACT
Purpose: The prevalence of physician burnout has risen and negatively impacts patient care, healthcare costs, and physician health. Medical students are heavily influenced by the medical teams they rotate with on the wards. We postulate that faculty well-being influences student perception of clerkships. Methods: Medical student evaluations core clerkships at one academic institution were compared with results of faculty well-being scores over 2 years (2018-2020). Linear mixed models were used to model each outcome adjusting for year, mean faculty distress score, and the standard deviation (SD) of WBI mean distress scores. Clerkships and students were treated as random effects. Results: Two hundred and eighty Well-Being Index evaluations by faculty in 7 departments (5 with reportable means and standard deviations), and clerkship evaluations by 223 students were completed. Higher faculty distress scores were associated with lower student evaluation scores of the clerkship (- 0.18 per unit increase in distress, std. err = 0.05, p < 0.01). Increased SD (variability) of faculty distress was associated with higher student overall ratings (0.49 points per unit increase in variability, std. err = 0.11, p < 0.01), as was year with 2019-2020 having lower overall ratings (- 0.17, std. err = 0.06, p < 0.01). Findings were similar for ratings of faculty teaching: mean faculty distress (- 0.15, std. err = 0.25), SD faculty distress (0.33, std. err = 0.12), 2019-2020 vs. 2018-2019 (- 0.19, std. err = 0.06) (all p < 0.01). Conclusions: Physician well-being is not only associated with quality of patient care and physician health, but also with medical student perceptions of clinical education. These findings provide yet another indirect benefit to improved physician well-being: enhanced undergraduate medical educational experience.
ABSTRACT
BACKGROUND: Grand rounds is an important and traditional academic medical institution. With generational changes in learning and the advancement of technology, it is difficult to know if the current method of grand rounds remains relevant and is meeting its audience's needs. Furthermore, surgeons may have different educational needs for grand rounds than other fields of healthcare. This study evaluates the needs of attendees and their attitudes toward modern surgical grand rounds through focus groups. MATERIALS AND METHODS: Independent focus groups were conducted in the department of surgery at a large academic institution. In total, 19 individuals (five professors, three associate professors, three assistant professors, seven senior residents, and one junior resident) participated in the focus groups. Thematic analysis was conducted through a process of independent coding and defining of themes followed by joint revision until consensus was reached. RESULTS: Four major themes arose from the discussion: current design and format of grand rounds, audience attitudes and needs, perceived barriers to meaningful grand rounds, and suggestions and improvements to grand rounds. Further subthemes also emerged. These themes were present in both faculty and resident responses, with 115 individual data pieces coded in total. CONCLUSIONS: Grand rounds is an opportunity for social interaction, networking, professional and personal identity formation, and learning meaningful and relevant content. Audience diversity, desire for more audience engagement, and changes in the modern learning environment provide the largest challenges to meaningful grand rounds. This first and interesting research into surgery grand rounds provides insight on how to best meet attendee needs in the 21st century.
