title: "Just be respectful of the primary doc": teaching mutual respect as a dimension of teamwork in general pediatrics.
abstract: OBJECTIVE
  Although others have reported on teamwork training, little is known about what pediatric residents in inpatient settings learn implicitly about respectful working relationships with community-based general pediatricians. The purpose of this brief report is to examine how pediatric residents on an inpatient general pediatric rotation regard "the other" (community-based general pediatricians), and how academic, hospital-based general pediatric attending physicians respond.
  
  
  METHODS
  We conducted a case study on one general pediatrics floor, which entailed 143 hours of observation over 8 months (January to August 2006), as well as in-depth interviews with 25 residents and 14 general pediatric attending physicians whom we observed as they worked on the floor. Data were derived from >1000 pages of field notes and interview transcripts. We systematically reviewed the data and inductively derived codes related to explicit and implicit education. In this brief report, we focused our analysis on data relevant to the concept of boundary crossing: when members of the group talk about members of another group in the process of inquiring about or negotiating patient care.
  
  
  RESULTS
  Residents' comments tended to reveal a neutral or somewhat negative regard for their general pediatric community counterparts, whom they typically referred to as PMDs (primary medical doctors). Attending physicians' responses to these comments varied, but often explicitly taught residents about dimensions of teamwork, including mutual respect.
  
  
  CONCLUSIONS
  Explicit teamwork training in pediatric education should not be limited to partnering with other disciplines or other specialties, but expanded to enhance positive regard and mutual respect for general pediatricians in hospital- and community-based settings alike. Attending physicians in general pediatrics are ideally positioned to implicitly teach respectful working relationships within the specialty.
authors.affiliation: Center for Education Research and Evaluation, Columbia University Medical Center, New York, NY 10032, USA. db2595@columbia.edu
authors.forename: Dorene F
authors.initials: DF
authors.lastname: Balmer
authors.forename: Boyd F
authors.initials: BF
authors.lastname: Richards
authors.forename: Angelo P
authors.initials: AP
authors.lastname: Giardino
mesh_terms: D003159:Community-Institutional Relations; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D007857:Leadership; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics / Q000193:education*; D056164:Teaching Rounds; D014481:United States