Measuring the use of the population perspective on internal medicine attending rounds.
Academic Article
Overview
abstract
BACKGROUND: The population perspective (risk-factor assessment, prevention, epidemiology, and the social aspects of illness) is increasingly important in medical school and residency curricula. The authors designed an observational study to assess the population-perspective content of internal medicine teaching rounds led by attending physicians at the Columbia-Presbyterian Medical Center. METHOD: During eight months in 1992 a trained research assistant used a structured observation form in observing attending rounds. Population scores were calculated by totaling the number of times population-perspective topics were mentioned during each case presentation (one point was awarded per mention, with an additional point being added for discussions lasting 30 seconds or more). Chi-square tests and unpaired t-tests were used to compare scores between teams with one generalist and one subspecialist attending physician and teams with two subspecialists. RESULTS: Fifteen teams and 368 patient presentations were observed. The mean population scores were 24.5 for teams with generalist attending physicians and 17.9 for teams with subspecialists only (p < .0001). The population scores for individual case presentations ranged from 2 to 55. CONCLUSION: The population-perspective topics were raised more frequently on the internal medicine teaching rounds when a generalist attending physician was present than when there were only subspecialist attending physicians.
