Attending rounds: What do the all-star teachers do?

Aim: To examine differences in the types of teaching activities performed during rounds between the most effective and least effective inpatient teaching attendings. Methods: Participants included 56 attending physicians supervising 279 trainees. Trained observers accompanied teams during rounds and recorded the frequencies of educational activities that occurred. Students and residents then rated their satisfaction with the teaching on rounds. Results: Attending physicians with the highest learner satisfaction scores performed significantly more teaching activities per patient than attending physicians who were rated as average or less-effective (2.1 vs. 1.4 vs. 1.5; p =.03). There were significant differences in the frequencies of 3 out of the 9 specific teaching activities observed, including answering specific patient-care related questions (77% vs. 66% vs. 47%; p =.003), teaching on learner chosen topics (8% vs. 2% vs. 2%; p =.02), and providing feedback (31% vs. 10% vs. 0.1%; p =.001). Conclusions: Specific categories of teaching activities—patient-specific teaching, teaching on learner-identified topics, and providing real-time feedback—are performed more frequently by the highest-rated attending physicians, which can guide faculty development.