SHM Converge Scientific Abstract ePoster Gallery-Challenges and Solutions for Inpatient Teaching Teams: A Multi-Center Study

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This multi-center qualitative study examined the growing tension between education and clinical care on Internal Medicine Teaching Teams (IMTTs), which are meant to provide both high-quality patient care and strong trainee learning. Using a constructivist grounded theory approach, the researchers interviewed 27 leaders from 20 academic training programs across the US and Canada.<br /><br />Participants agreed that IMTTs remain highly valuable in medical education, but increasing patient volume, case complexity, throughput pressure, and fragmented interprofessional workflows are making it harder to achieve both educational and clinical goals. These pressures can reduce care quality, weaken learning opportunities, and harm faculty and trainee wellness.<br /><br />The study found that programs often rely on reactionary “workarounds” to deal with immediate problems, but these fixes may create new issues. The researchers identified six modifiable design elements that influence whether teams succeed or struggle:<br /><br />1. Patient mix and census  <br />2. Leadership collaboration  <br />3. Collaborative care models  <br />4. Rotation scheduling  <br />5. Clinical workflow  <br />6. Educational workflow  <br /><br />Supportive practices included capped patient loads, case-mix planning, strong leader collaboration, geographically co-located patients, stable team size, balanced rotation length, time for bedside teaching, and meaningful observation and feedback. Undermining factors included too many or inappropriate patients, poor leadership relationships, siloed workflows, inconsistent team composition, excessive discharge pressure, and too much emphasis on accreditation requirements over bedside learning.<br /><br />Overall, the authors conclude that IMTTs are facing major challenges in today’s clinical environment, but their framework can help leaders proactively identify problems and redesign team structures to better support care, education, and clinician well-being.

Asset Subtitle

John Ratelle

Meta Tag

Author List Aishwarya Kulkarni, Erin Spicer, Gretchen Colbenson, Janet Record, John Ratelle, Kristen A. Bishop, Mark Goldszmidt

Category Research

Concept Inpatient Teaching Team

Concept Patient Care

Concept Clinical Education

Concept Patient Volume

Concept Patient Complexity

Distinguished Non-Finalist

Presenter Organization Mayo Clinic, Rochester MN

Presenting Author John Ratelle

Track Education

Keywords

Internal Medicine Teaching Teams

medical education

clinical care

qualitative study

constructivist grounded theory

patient volume

team workflow

faculty wellness

trainee learning

healthcare leadership

Inpatient Teaching Team

Patient Care

Clinical Education

Patient Volume

Patient Complexity