• Catherine Callister, Gopi Astik, R Matthew Atkins, Angela Alday, Khooshbu Dayton, Angela Keniston, Anne Linker, Lauren McBeth, John Merriman, Sara Westergaard, Amy Yu, Andrew Auerbach, and Marisha Burden.
• Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
• J Hosp Med. 2024 Dec 15.

BackgroundAcademic medical centers are experiencing rapid clinical growth which has outpaced traditional teaching services. Learners such as medical students, advanced practice provider fellows, and residents may be placed onto direct care teaching services (i.e., inpatient services where attendings provide both direct care to patients and supervise learners) creating potential challenges for attending physicians due to clinical demands.ObjectiveCharacterize the hospitalist experience with direct care teaching services.MethodsEmbedded mixed methods study with a 16-question survey and semistructured focus groups using rapid qualitative methods.Setting And ParticipantsVirtual focus groups in the Hospital Medicine Reengineering Network (HOMERuN).Main Outcome And MeasuresQualitative themes.ResultsThirty-eight hospitalist clinicians from 26 hospital systems across five geographic regions participated in the focus groups. Thirty-four (89%) of participants responded to the survey and were predominantly physicians (97%). Most participants preferred traditional teaching services compared with direct care teaching services with 82% replying somewhat or to a great extent. Thematic analysis identified three themes: (1) Hospitalists prefer traditional teaching services in part due to a time and workload mismatch in direct care teaching services; (2) Adaptations can support attending physicians in direct care teaching services such as adjusting workloads based on the level of learners; and (3) Direct care teaching services were perceived to serve an important role by providing direct and personalized teaching, and offering teaching opportunities.ConclusionDirect care teaching services pose challenges given clinical workloads, time constraints for educational activities. Addressing these challenges may make these types of services more sustainable.© 2024 Society of Hospital Medicine.

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