title: Medical students' experiences working with frequently rotating pediatric inpatient attending physicians.
abstract: OBJECTIVE
  To explore medical students' experiences working with frequently rotating pediatric inpatient attending physicians.
  
  
  METHODS
  We performed a qualitative study using focus groups and individual interviews of medical students who rotated on the general pediatric inpatient service at Children's Hospital Colorado. The majority of inpatient pediatric attending physicians worked 1-week blocks. We used a semistructured interview guide and analyzed data using the constant comparative method. In accordance with the grounded theory method, codes were developed using an iterative approach, and major themes were identified. Analysis indicated theoretical saturation was achieved. We created a theory that arose from analysis of the data.
  
  
  RESULTS
  Twenty-seven medical students participated. Data analysis yielded 6 themes: learning climate, continuity, student resilience, opportunity to progress, growth into a physician, and evaluation. In the learning climate, the emotional environment was often stressful, although students valued exposure to different patient care and teaching styles. Senior resident continuity promoted student function; lack of continuity with attending physicians inhibited relationship development. Students were resilient in adjusting to changing faculty with different expectations. In the context of frequently rotating faculty, students had difficulty showing improvement to a single attending physician after feedback, which limited students' opportunities to progress. Students perceived summative evaluation as less meaningful in the absence of having a relationship with their attending physicians.
  
  
  CONCLUSIONS
  Medical students valued exposure to different patient care and teaching styles. However, frequently changing attending physicians caused students stress and limited students' perceived ability to achieve and show professional growth.
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine leonard.seltz@childrenscolorado.org.
authors.forename: L Barry
authors.initials: LB
authors.lastname: Seltz
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine.
authors.forename: Alison
authors.initials: A
authors.lastname: Montgomery
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine.
authors.forename: J Lindsey
authors.initials: JL
authors.lastname: Lane
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Soep
authors.affiliation: Children's Hospital Colorado and University of Colorado School of Medicine.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Hanson
mesh_terms: D001291:Attitude of Health Personnel; D004504:Education, Medical, Undergraduate; D005180:Faculty, Medical; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000193:education*; D010561:Personnel Staffing and Scheduling; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*
keywords: hospital medicine; medical education