Pediatric EducationExam Room Presentations and Teaching in Outpatient Pediatrics: Effects on Visit Duration and Parent, Attending Physician, and Resident Perceptions
Section snippets
Study Setting and Population
The Pediatric Primary Care Center (PPCC) at the Cincinnati Children's Hospital Medical Center is a large, hospital-based pediatric primary care provider to a diverse socioeconomic and ethnic population. The PPCC is the continuity site for 50 pediatric residents (about one third of the pediatric residents from the residency training program) and also serves as a training site for residents on their primary care, outpatient rotation (60 per year) and for medical students (50 per year).
Results
All eligible first-year residents (n = 15, 9 female and 6 male) and all eligible attending physicians (n = 15, 9 female and 6 male) consented to participate and completed the surveys. Attending physicians had an average of 10 years experience (range, 2–30 years) postresidency training.
Three hundred seventy-four PPCC visits were eligible (272 well-child visits and 102 ill-child visits). However, the research assistant was unable to approach all of these patients because sometimes more than 1
Discussion
To our knowledge, this is the first study of ERPT in a pediatric outpatient setting. This builds on the work of Orsetti and Williams,6 Smith et al,7 Anderson et al,8 and Rogers et al,9 who studied this method in other outpatient settings. We found that location of presentation and discussion of patient information does not affect visit duration or parent satisfaction and comfort level with the resident-patient relationship. Resident and attending physician ratings favored the exam room location
Conclusions
Exam room presentations and discussions add value in the outpatient pediatric setting. With increasing emphasis on family-centered care and involvement of families in decision making, bedside teaching appears to be an appropriate approach in both the inpatient and outpatient arena. Although this does create some discomfort in residents, especially early in their training, this should diminish with experience as suggested in the adult literature. Advantages to parents are involvement in decision
References (22)
- et al.
Outpatient case presentations in the conference room versus examination room: results from two randomized controlled trials
Am J Med
(2002) - et al.
Bedside teaching
South Med J
(1997) 42 Code of Federal Regulations 415.174
Exception: Evaluation and Management Services Furnished in Certain Centers
(2006)- et al.
The Picker Patient Experience Questionnaire: development and validation using data from in-patient surveys in five countries
Int J Qual Health Care
(2002) - et al.
Psychometric properties of the CAHPS 1.0 survey measures
Med Care
(1999) Cronbach's alpha: a tool for assessing the reliability of scales
J Extension
(1999)- et al.
“In-room” presentation in the ambulatory setting
J Gen Intern Med
(1998) - et al.
The use of “clinic room” presentation as an educational tool in the ambulatory care setting
Neurology
(1999) - et al.
Examination room presentations in general internal medicine clinic: patients' and students' perceptions
Acad Med
(2003) - et al.
The effect of bedside case presentation on patients' perceptions of their medical care
N Engl J Med
(1997)
Bedside case presentation: why patients like them but learners don't
J Gen Intern Med
Cited by (0)
Presented at the 2006 Pediatric Academic Societies Annual Meeting, San Francisco, Calif, May 2006.