title: Intensive Care Unit Educators: A Multicenter Evaluation of Behaviors Residents Value in Attending Physicians.
abstract: BACKGROUND
  It is important for attending physicians to know which behaviors influence learner perceptions. To date, two studies focusing on general medicine attending physicians have been published addressing internal medicine residents' perceptions of attending physicians; there are no data on intensive care unit (ICU) attending physicians.
  
  
  OBJECTIVE
  We sought to expand the evidence regarding this topic through a multicenter study at four geographically diverse academic medical centers. Our study focused on identifying the teaching behaviors of ICU physicians that learners observe in attending physicians who they value as effective educators.
  
  
  METHODS
  The study was conducted at Indiana University (Indianapolis, IN), Johns Hopkins University (Baltimore, MD), University of California-San Francisco (San Francisco, CA), and University of Washington (Seattle, WA). Internal medicine residents completed an anonymous online survey rating the importance of behaviors of ICU attending physician role models. We created a 37-item questionnaire derived from prior studies and from the Clinician Teaching Program from the Stanford Faculty Development Center for Medical Teachers. This questionnaire included behaviors, current and past, that residents observed in their ICU attending physicians.
  
  
  RESULTS
  A total of 260 of 605 residents responded to the survey (overall response rate of 43%). The five behaviors of attending physicians most commonly rated as "very important" to residents were: (1) enjoyment of teaching; (2) demonstrating empathy and compassion to patients and families; (3) ability to explain clinical reasoning and differential diagnoses; (4) treating nonphysician staff members respectfully; and (5) enthusiasm on rounds. Behaviors that trainees rated as less important were having numerous research publications, having served as chief resident, sharing personal life with residents, and organizing end-of-rotation social events.
  
  
  CONCLUSIONS
  Our study provides new information to attending physicians striving to influence resident education. Although prior data demonstrated that learners valued attending physicians having served as chief resident and sharing personal information with learners, our study did not replicate this. We confirmed that learners appreciated teachers who are perceived to enjoy teaching. We discovered that behaviors, such as expression of empathy, explanation of clinical reasoning, and qualities of professionalism, were commonly seen in esteemed teaching attending physicians. Our study was limited by lack of correlation to objective performance metrics and a low response rate. Future work may include assessing the impact of faculty development on identified behaviors.
authors.affiliation: 1 Department of Medicine, University of California-San Francisco, San Francisco, California.
authors.forename: Lekshmi
authors.identifier: http://orcid.org/0000-0002-9897-3462
authors.initials: L
authors.lastname: Santhosh
authors.affiliation: 2 Department of Medicine, University of Texas-Southwestern, Dallas, Texas.
authors.forename: Snigdha
authors.initials: S
authors.lastname: Jain
authors.affiliation: 3 Department of Medicine, University of Washington, Seattle, Washington.
authors.forename: Anna
authors.initials: A
authors.lastname: Brady
authors.affiliation: 4 Department of Medicine, Johns Hopkins University, Baltimore, Maryland; and.
authors.forename: Michelle
authors.initials: M
authors.lastname: Sharp
authors.affiliation: 5 Department of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: W Graham
authors.initials: WG
authors.lastname: Carlos
mesh_terms: D000046:Academic Medical Centers; D002983:Clinical Competence; D003422:Critical Care; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D005180:Faculty, Medical; D006801:Humans; D007362:Intensive Care Units; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D010817:Physician-Patient Relations; D011361:Professional Competence; D066107:Social Skills; D011795:Surveys and Questionnaires; D013663:Teaching
keywords: critical care; education techniques; graduate medical education; medical education; survey methodology