182 - The Realities of Implementing a Novel Hospital Medicine-Based Teaching and Feedback Program: A Qualitative Study of What Stakeholders Need to Know

Publication Number: 182.6754

Kathleen G. Brimsek, University of Colorado School of Medicine, Centennial, CO, United States; Lauren R. Anderson, University of Colorado School of Medicine, Aurora, CO, United States; Lee Engelbreth, Children's Hospital Colorado, Broomfield, CO, United States; Francesca E. Moisson, Children's Hospital Colorado, Denver, CO, United States; Janice Hanson, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Kimberly O'Hara, University of Colorado School of Medicine, Denver, CO, United States; Jessica Landry, University of Colorado School of Medicine, Aurora, CO, United States

Background: Program development requires thoughtful planning to align goals with outcomes, plus evaluation to monitor its effectiveness and value. We created the “Teaching Excellence Among Medical providers” (TEAM) Program to better support the professional development of learners and faculty. This program requires ample resources, and while prior studies have shown measures of its success, the challenges associated with the TEAM Program also require exploration.

Objective: To evaluate a pediatric hospital medicine (PHM) teaching program and describe its disadvantages as perceived by program stakeholders

Design/Methods: In 2019, we developed the TEAM Program based on self-regulated learning theory. Funded by the Department of Pediatrics, 12 PHM faculty receive 0.1 FTE to join TEAM and observe learners and faculty and provide feedback, conduct teaching sessions, and complete written evaluations. Another faculty member receives 0.1 FTE to manage the program. TEAM operates 4 days/week on the PHM services at our free-standing children’s hospital. In a larger qualitative study we evaluated TEAM through semi-structured, 1:1 interviews with program stakeholders plus field observations of TEAM in action. We coded interview transcripts and field notes individually, as pairs, and then as a group, reconciling codes and performing content analysis until thematic saturation was achieved. This abstract reports the data pertaining to program outcomes described as areas for improvement or challenges.

Results: We conducted 25 interviews (Table 1) and 10 field observations (Table 2) over 16 months in 2023-2024. While the majority of experiences were positive, data analysis revealed an infrequent subset of themes and subthemes related to the disadvantages of TEAM (Table 3): 1) Barriers preventing engagement with TEAM (e.g. logistics, burn out), 2) Factors associated with ineffective TEAM feedback (e.g., lack of continuity), 3) Observation by TEAM may adversely affect the medical team (increased pressure), 4) Overlapping roles between TEAM faculty and clinical team leaders, 5) System factors that put TEAM sustainability at risk (e.g., financial costs, scheduling barriers).

Conclusion(s): Program evaluation of TEAM revealed areas for targeted improvement and the results provide transparency around the challenges faced in implementing this educational program. Such challenges should be considered when developing similar teaching programs in other settings. Next steps include addressing these disadvantages to enhance TEAM and continue to meet program goals, including schedule optimization and enhancing communication with the clinical team.

Table 3
Themes and sub-themes, along with representative quotes of each, regarding areas of improvement for the TEAM Program

Table 1
Demographics of program stakeholders who were interviewed about their experiences with TEAM as part of the qualitative study (Leadership roles include training program directors, associate program directors, medical student course directors, and Section Heads)

Table 2
Distinct hospital ward activities observed during field observations of TEAM hospitalist shifts as part of the qualitative study