Online Poster Portal

  • Author
    Luigi Varilla
  • Discovery PI

    Catherine Yu, MD

  • Project Co-Author

    Luigi Varilla

  • Abstract Title

    Impact and Influence of a Teaching Resident (TR) Rotation on Emergency Medicine Residents

  • Discovery AOC Petal or Dual Degree Program

    Medical Educaion & Leadership

  • Abstract

    Title: Impact and Influence of a Teaching Resident (TR) Rotation on Emergency Medicine Residents

    Author: Luigi Varilla; Catherine Yu, MD

    Area of Concentration (Petal): Medical Education & Leadership

    Specialty (if any): Emergency Medicine

    Keywords: Teaching Rotation Emergency Medicine Residency

    Background: Many emergency medicine residency programs have a dedicated teaching rotation

    or experience in medical education where senior residents are responsible for teaching and

    supervising learners in the department, commonly medical students, interns, or junior residents.

    Studies have shown that TR rotations improve procedural skills, medical knowledge and patient

    care [1], however there is limited research on the impact of these rotations on the residents who

    participated. The impact of these rotations on the teaching residents after graduation is also not

    known.

    Objective: We hope to provide a qualitative description of the impact of TR rotations on career

    trajectory, transition to attending or fellow role, and teaching/supervisory skill acquisition on

    emergency medicine residents.

    Methods: We conducted a qualitative study using semi-structured interviews through Zoom.

    Participants were 11 UCLA/Olive View Emergency Medicine residency alumni from the classes

    of 2021 and 2022, We completed the data analysis using an inductive thematic approach. Two

    investigators independently reviewed and coded the interview transcriptions, then met to form

    the final list of codes that were then used to generate themes.

    Results:

    Based on our analysis, we were able to generate the following codes: 

    Table 1.  Codes and Definitions

    Code

    Definition

    Transition to attending physician or fellow role

    Experiences and lessons learned from the TR rotation help prepare the resident for their new role as an attending physician or as a fellow

    Improve own medical knowledge

    The act of teaching during the TR rotation requires the resident to check and review their own medical knowledge as well as think of opportunities to teach beyond what can be learned from a textbook

    Develop teaching style

    TR rotation allows the resident to develop specific teaching skills such as bedside teaching and teaching procedures

    Build relationships with learners

    TR rotation allows the resident to foster relationships and set boundaries with your learners

    Develop preference for and tailor to different learners and levels

    Being a teacher requires the resident to understand the needs of different learners and what expectations to have for different learner levels, which can change the teaching experience

    Balance clinical and teaching duties

    TR rotation helps the resident learn how to balance patient care with teaching responsibilities

    Give and receive feedback

    TR rotation creates opportunities to give and receive feedback to/from learners

    Appreciation for education

    TR rotation increases the resident’s appreciation for the culture of education and wanting to contribute to the education of others

    Recognize limitations of learners

    Teaching requires the resident to understand the knowledge deficiencies and/or skill limitations of learners and how that could translate to their care of patients

    Loss of sense of autonomy

    The resident feels a loss of autonomy and direct involvement in patient care by being a supervisor and allowing for more hands-on experiences for learners

    Develop management style

    Understanding which situations to oversee more carefully vs stepping back to give the learner more autonomy; finding the balance between being helpful vs being overbearing

    Influence on career decision

    TR experience helped influence the resident’s decision whether or not to pursue an academic career or teaching role post-residency

    These codes were then grouped into the following themes:

    Table 2. Themes and Associated Codes

    Codes

    Theme
    • Develop teaching style
    • Appreciation for education
    • Loss of sense of autonomy

    Discovery of teaching identity
    • Develop preference for and tailor to different learners and levels
    • Recognize limitations of learners

    Developing teaching skills
    • Balance clinical and teaching duties
    • Develop management style

    Developing supervisory skills
    • Transition to attending physician or fellow role
    • Improve own medical knowledge
    • Influence on career decision

    Professional development
    • Build relationships with learners
    • Give and receive feedback

    Communication skills

    Conclusions:

    Based on our thematic analysis, we found that the TR rotation improved clinical knowledge,

    appreciation for relationship building with learners, and building teaching skills. However,

    interviewees also noted the loss of sense of autonomy, difficulty balancing clinical and teaching

    responsibilities, and finding challenges in teaching specific learners, such as medical students as

    compared to residents. Overall, the TR rotation did not change residents’ career choices.

    Residents that entered residency wanting to go into academic medicine found it reassuring to

    participate in the rotation while those wanting to go into community found the rotation to be a

    reaffirmation of their decision not to teach.Limitations in this study include the smaller sample size and the similar graduation years of the

    interviewees. We also recognize that all the interviewees came from the same residency program.

    Future studies could tailor to a larger sample size across multiple residency programs and

    hospital settings.

    We hope that our study encourages other residency programs to consider a TR rotation and for

    those already with similar rotations, we hope that our study informs programs of the potential

    impact of their TR rotation.

Back