title: Characteristics of Highly Rated Internal Medicine Attendings Before and After the 2004 Work-Hour Restrictions.
abstract: OBJECTIVE
  To describe the characteristics of top-rated Internal Medicine attendings and whether they changed after implementation of the 2004 work-hour restrictions.
  
  
  METHODS
  Mixed methods study of resident ratings of medicine attendings (Period 1: 1994-1996, n = 250 and Period 2: 2007-2009, n = 152). Residents evaluated 17 attending characteristics. The top 25% of "overall" ratings were classified as "highly rated." Two free-text questions included "What was your attending's best characteristic?" and "How could your attending best improve?" and were coded in duplicate, using grounded qualitative methods.
  
  
  RESULTS
  There were no differences in the characteristics of highly rated attendings in the two time periods. Characteristics associated with being a top-rated attending included enthusiasm (odds ratio [OR]: 5.69, 2.78-11.67), balanced teaching style (OR: 3.63, 1.64-8.02), promoting independent thinking (OR: 2.90, 0.96-8.74), fund of knowledge (OR: 2.73, 1.13-6.58), and time management (OR: 1.78, 1.14-2.80). Among the 1,410 utterances, valued attending attributes included helpfulness, promoting independent thinking, and having strong medical knowledge.
  
  
  CONCLUSIONS
  The characteristics valued by residents in attendings did not change over time despite a major structural change in work hours and patterns of teaching. These valued characteristics continue to be a strong general fund of knowledge, enthusiasm for teaching, and balance between didactic and bedside approaches.
authors.affiliation: Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Renee
authors.initials: R
authors.lastname: Mallory
authors.affiliation: Department of Medicine, Zablocki VAMC, 5000 W National Avenue, Milwaukee, WI 53295.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Jackson
authors.affiliation: Department of Medicine, Dwight D Eisenhower Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905.
authors.forename: Donald
authors.initials: D
authors.lastname: Mondragon
authors.affiliation: Department of Medicine, Dwight D Eisenhower Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905.
authors.forename: Christos
authors.initials: C
authors.lastname: Hatzigeorgiou
authors.affiliation: Graduate Medical Education, Tripler Army Medical Center, 1 Jarrett White Road Honolulu, HI 96859.
authors.forename: Kent J
authors.initials: KJ
authors.lastname: DeZee
authors.affiliation: Department of Ophthalmology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: David
authors.initials: D
authors.lastname: Greenburg
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Malley
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000331:legislation & jurisprudence; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence / Q000523:psychology*; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence*