title: The prevalence of social and behavioral topics and related educational opportunities during attending rounds.
abstract: OBJECTIVE
  To quantify the prevalence of social and behavioral sciences (SBS) topics during patient care and to rate team response to these topics once introduced.
  
  
  METHODS
  This cross-sectional study used five independent raters to observe 80 inpatient ward teams on internal medicine and pediatric services during attending rounds at two academic hospitals over a five-month period. Patient-level primary outcomes-prevalence of SBS topic discussions and rate of positive responses to discussions-were captured using an observational tool and summarized at the team level using hierarchical models. Teams were scored on patient- and learner-centered behaviors.
  
  
  RESULTS
  Observations were made of 80 attendings, 83 residents, 75 interns, 78 medical students, and 113 allied health providers. Teams saw a median of 8.0 patients per round (collectively, 622 patients), and 97.1% had at least one SBS topic arise (mean = 5.3 topics per patient). Common topics were pain (62%), nutrition (53%), social support (52%), and resources (39%). After adjusting for team characteristics, the number of discussion topics raised varied significantly among the four services and was associated with greater patient-centeredness. When topics were raised, 38% of teams' responses were positive. Services varied with respect to learner- and patient-centeredness, with most services above average for learner-centered, and below average for patient-centered behaviors.
  
  
  CONCLUSIONS
  Of 30 SBS topics tracked, some were addressed commonly and others rarely. Multivariable analyses suggest that medium-sized teams can address SBS concerns by increasing time per patient and consistently adopting patient-centered behaviors.
authors.affiliation: Dr. Satterfield is professor of clinical medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, California. Dr. Bereknyei is a research scholar, Stanford Center for Medical Education Research and Innovation, Stanford University, Stanford, California. Dr. Hilton is professor, Division of Biostatistics, University of California, San Francisco, San Francisco, California. Ms. Bogetz is project coordinator, Division of General Internal Medicine, University of California, San Francisco, San Francisco, California. Dr. Blankenburg is clinical assistant professor, General Pediatrics, Stanford University, Stanford, California. Dr. Buckelew is associate clinical professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. Dr. Chen is professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. Dr. Monash is assistant professor, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California. Ms. Ramos is program coordinator, Stanford Center for Medical Education Research and Innovation, Stanford University, Stanford, California. Dr. Rennke is assistant professor, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California. Dr. Braddock is vice dean for medical education, University of California, Los Angeles, Los Angeles, California.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Satterfield
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bereknyei
authors.forename: Joan F
authors.initials: JF
authors.lastname: Hilton
authors.forename: Alyssa L
authors.initials: AL
authors.lastname: Bogetz
authors.forename: Rebecca
authors.initials: R
authors.lastname: Blankenburg
authors.forename: Sara M
authors.initials: SM
authors.lastname: Buckelew
authors.forename: H Carrie
authors.initials: HC
authors.lastname: Chen
authors.forename: Bradley
authors.initials: B
authors.lastname: Monash
authors.forename: Jacqueline S
authors.initials: JS
authors.lastname: Ramos
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rennke
authors.forename: Clarence H
authors.initials: CH
authors.lastname: Braddock
mesh_terms: D000046:Academic Medical Centers; D001519:Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007388:Internal Medicine / Q000193:education*; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D015999:Multivariate Analysis; D010348:Patient Care Team / Q000458:organization & administration; D010372:Pediatrics / Q000193:education*; D010817:Physician-Patient Relations; D015995:Prevalence; D012919:Social Behavior; D056164:Teaching Rounds; D014481:United States