title: A randomized trial of an intervention to improve resident-fellow teaching interactions on the wards.
abstract: BACKGROUND
  Subspecialty fellows can serve as a tremendous educational resource to residents; however, there are multiple barriers to an effective resident-fellow teaching interaction in the setting of inpatient consultation. We designed and evaluated a resident-directed intervention to enhance communication and teaching during consultation on the general medicine wards.
  
  
  METHODS
  Five medical teams were randomized to receive the intervention over a 3 month period (3 control, 2 intervention teams). The intervention was evaluated with pre and post-intervention surveys.
  
  
  RESULTS
  Fifty-nine of 112 interns completed the pre-intervention survey, and 58 completed the post-intervention survey (53 % response rate). At baseline, 83 % of the interns noted that they had in-person interactions with fellows less than 50 % of the time. 81 % responded that they received teaching from fellows in less than 50 % of consultations. Following the intervention, the percentage of interns who had an in-person interaction with fellows greater than 50 % of the time increased in the intervention group (9 % control versus 30 % intervention, p = 0.05). Additionally, interns in the intervention group reported receiving teaching in more than 50 % of their interactions more frequently (19 % control versus 42 % intervention, p = 0.05). There were no differences in other measures of teaching and communication.
  
  
  CONCLUSIONS
  We demonstrate that a time-efficient intervention increased perceptions of in-person communication and the number of teaching interactions between interns and fellows. Further studies are warranted to determine whether such an approach can impact resident learning and improve patient care.
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, USA.
authors.forename: Jehan
authors.initials: J
authors.lastname: Alladina
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Heaton
authors.affiliation: Division of Rheumatology, Department of Medicine, Massachusetts General Hospital, Yawkey Center for Outpatient Care, Harvard Medical School, 55 Fruit Street, Suite 2C, Boston, MA, 02114, USA. Emiloslavksy@partners.org.
authors.forename: Eli
authors.initials: E
authors.lastname: Miloslavsky
mesh_terms: D003142:Communication; D005257:Fellowships and Scholarships; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D012017:Referral and Consultation; D013663:Teaching; D014481:United States
keywords: Communication; Fellows; Inpatient subspecialty consultation; Internal medicine; Residents; Teaching interaction