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Karen E. Hauer, MD; Robert M. Wachter, MD; Charles E. McCulloch, PhD; Garmen A. Woo, BS; Andrew D. Auerbach, MD, MPH

Arch Intern Med. 2004;164:1866-1871.

Background  Hospitalists are increasingly serving as inpatient attendings at teaching hospitals. The educational impact of this new model is unclear. We evaluated the relationship between type of attending (hospitalist vs traditional) and trainees' ratings of attending teaching and the overall ward rotation.

Methods  We analyzed data from a Web-based evaluation system containing all house staff and student evaluations of their attendings and internal medicine ward rotations at 2 university-affiliated teaching hospitals over a 2-year period (1999-2001).

Results  The overall evaluation completion rate was 91% (1587 of 1742 evaluations) by trainees working with 17 hospitalists and 52 traditional attendings. Trainees reported significantly more overall satisfaction with hospitalists than traditional attendings (8.3 vs 8.0 on a 9-point scale; P<.001) and rated hospitalists' overall teaching effectiveness as superior (4.8 vs 4.5 on a 5-point scale; P<.001). Perceived overall educational value of rotations was higher with hospitalist attendings (3.9 vs 3.7 on a 5-point scale; P = .04). Trainees evaluated hospitalists' knowledge, teaching, and feedback as superior to that of traditional attendings. There were no significant differences in reports of attendings' interest in teaching or patients, availability, or emphasis on cost-effectiveness.

Conclusions  Trainees reported more effective teaching and more satisfying inpatient rotations when supervised by hospitalists. This analysis suggests that hospitalists may possess or accrue a specific inpatient knowledge base and teaching skill that distinguishes them from nonhospitalists.

From the Departments of Medicine (Drs Hauer, Wachter, and Auerbach) and Epidemiology and Biostatistics (Drs Wachter and McCulloch), University of California, San Francisco; and St George's University School of Medicine, Grenada, West Indies (Ms Woo). The authors have no relevant financial interest in this article.

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