Journal of hospital medicine最新文献

{"title":"Things We Do for No Reason™: Discontinuing anticoagulation in older patients with atrial fibrillation and a high risk of falls","authors":"Samantha Wang MD, MHS,&nbsp;Matthew Mesias MD","doi":"10.1002/jhm.13464","DOIUrl":"10.1002/jhm.13464","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"288-290"},"PeriodicalIF":2.4,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing electronic messaging use among hospitalists and its association with patient volumes","authors":"Claire Brickson MD,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Michelle Knees DO,&nbsp;Marisha Burden MD, MBA","doi":"10.1002/jhm.13462","DOIUrl":"10.1002/jhm.13462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Secure electronic messaging is increasingly being utilized for communications in healthcare settings. While it likely increases efficiency, it has also been associated with interruptions, high message volumes, and risk of errors due to multitasking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to characterize patterns of secure messaging among hospitalists to understand the volume of messages, message patterns, and impact on hospitalist workload.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cross-sectional study of Epic Secure Chat secure electronic messages received and sent by hospitalists from April 1 to April 30, 2023 at a large academic medical center. Number of conversations per day, number of chats sent and accessed per hour, and average minutes between when a chat was sent and accessed (lag time) were analyzed using a Pearson correlation coefficient test. Measures were plotted against patient volume and time of day.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hospitalists sent or received an average of 130 messages per day with an average of 13 messages sent or received per hour. The median lag time was 39 s. There was a statistically significant correlation between hospital medicine morning census and number of conversations per day, number of chats sent per hour, and number of chats accessed per hour, but census did not impact lag time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Secure messaging volumes may be higher than previously reported, which may affect hospitalist workload and workflow and have unintended effects on interruptions, multitasking, and medical errors. Additional work should be done to better understand local messaging patterns and opportunities to optimize volume of work and distractions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1131-1137"},"PeriodicalIF":2.4,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study","authors":"Nazima Allaudeen MD,&nbsp;Joyce Akwe MD,&nbsp;Cherinne Arundel MD,&nbsp;Joel C. Boggan MD,&nbsp;Peter Caldwell MD,&nbsp;Paul B. Cornia MD,&nbsp;Jessica Cyr MD,&nbsp;Erik Ehlers MD,&nbsp;Joel Elzweig MD,&nbsp;Patrick Godwin MD,&nbsp;Kirsha S. Gordon PhD, MS,&nbsp;Michelle Guidry MD,&nbsp;Jeydith Gutierrez MD, MPH,&nbsp;Daniel Heppe MD,&nbsp;Matthew Hoegh MD,&nbsp;Anand Jagannath MD,&nbsp;Peter Kaboli MD, MS, FACP, FHM,&nbsp;Michael Krug MD,&nbsp;James D. Laudate MD,&nbsp;Christine Mitchell MD,&nbsp;Micah Pescetto DO,&nbsp;Benjamin A. Rodwin MD,&nbsp;Matthew Ronan MD,&nbsp;Richard Rose MD,&nbsp;Meghna N. Shah MD,&nbsp;Andrea Smeraglio MD,&nbsp;Meredith Trubitt MD,&nbsp;Matthew Tuck MD,&nbsp;Jaclyn Vargas MD,&nbsp;Peter Yarbrough MD,&nbsp;Craig G. Gunderson MD","doi":"10.1002/jhm.13458","DOIUrl":"10.1002/jhm.13458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study evaluated veterans admitted for alcohol withdrawal to medical services at 19 Veteran Health Administration hospitals between October 1, 2018 and September 30, 2019. Factors associated with all-cause 30-day readmission and 6-month abstinence were examined using logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 594 patients included in this study, 296 (50.7%) were prescribed medications for AUD at discharge and 459 (78.5%) were discharged with follow-up appointments, including 251 (42.8%) with a substance-use clinic appointment, 191 (32.9%) with a substance-use program appointment, and 73 (12.5%) discharged to a residential program. All-cause 30-day readmission occurred for 150 patients (25.5%) and 103 (17.8%) remained abstinent at 6 months. Medications for AUD and outpatient discharge appointments were not associated with readmission or abstinence. Discharge to residential treatment program was associated with reduced 30-day readmission (adjusted odds ratio [AOR]: 0.39, 95% confidence interval [95% CI]: 0.18–0.82) and improved abstinence (AOR: 2.50, 95% CI: 1.33–4.73).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Readmission and return to heavy drinking are common for patients discharged for alcohol withdrawal. Medications for AUD were not associated with improved outcomes. The only intervention at the time of discharge that improved outcomes was discharge to residential treatment program, which was associated with decreased readmission and improved abstinence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1122-1130"},"PeriodicalIF":2.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guideline highlights for the hospitalist: International consensus criteria for pediatric sepsis and septic shock","authors":"James A. Watson MD,&nbsp;Nichole Samuy MD, MSHI","doi":"10.1002/jhm.13459","DOIUrl":"10.1002/jhm.13459","url":null,"abstract":"<p><b>GUIDELINE TITLE</b>: International Consensus Criteria for Pediatric Sepsis and Septic Shock</p><p><b>RELEASE DATE</b>: January 21, 2024</p><p><b>PRIOR VERSION(S)</b>: International Pediatric Sepsis Consensus Conference: Definitions for Sepsis and Organ Dysfunction in Pediatrics (2005)</p><p><b>DEVELOPER</b>: Society of Critical Care Medicine</p><p><b>FUNDING SOURCE</b>: Society of Critical Care Medicine (grant R01HD105939 from the National Institute of Child Health and Human Development)</p><p><b>TARGET POPULATION</b>: Children with sepsis and septic shock</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 11","pages":"1037-1039"},"PeriodicalIF":2.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition in hospitalized adults in the United States, 2016–2019","authors":"Ajay Bhasin MD,&nbsp;Lynn Huang MS,&nbsp;Meng-Shoiu Shieh PhD,&nbsp;Penelope Pekow PhD,&nbsp;Peter K. Lindenauer MD, MS,&nbsp;Tara Lagu MD, MPH","doi":"10.1002/jhm.13456","DOIUrl":"10.1002/jhm.13456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malnutrition in hospitalized patients is associated increased length of stay, cost, readmission, and death. No recent studies have examined trends in prevalence or outcomes of hospitalized patients with a diagnosis of malnutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study the prevalence of malnutrition diagnostic codes and associated hospital outcomes in the United States between 2016 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective trends study to identify use of malnutrition codes in hospitalizations in the National Inpatient Sample between 2016 and 2019. We used direct standardization by logistic regression to adjust outcomes of percutaneous gastrostomy tube placement, mechanical ventilation, and death for age, Gagne comorbidity score, and sex. We then used linear regression to test for trends over time by malnutrition type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across all hospitalizations, codes for diagnoses of nonsevere malnutrition and severe malnutrition were present in 3.7% and 4.1% of hospitalizations, respectively. Codes for any malnutrition increased over time, from 6.6% in 2016 to 8.6% in 2018 (<i>p</i> = .03). Codes for severe malnutrition increased from 3.3% to 4.7% (<i>p</i> = .01). Among hospitalizations with coded severe malnutrition diagnoses, there was a statistically significant decrease in adjusted rate of death over time (−0.54% per year, <i>p</i> = .03) which was not seen in hospitalizations without coded malnutrition diagnoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Use of malnutrition diagnosis codes increased significantly from 2016 to 2019. During this time, mortality among hospitalizations with a diagnosis code for severe malnutrition decreased. Though the increased prevalence of malnutrition codes may represent a change in the clinical characteristics of hospitalized patients, the decline in mortality suggests some of the increase may be due to lower threshold for coding and assignment of the diagnosis to less ill patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1113-1121"},"PeriodicalIF":2.4,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A beginner's guide to manuscript publication: Your paper is published, now what?","authors":"Joseph S. Thomas MD,&nbsp;Catherine Glatz MD,&nbsp;Maha Suleiman MD,&nbsp;Patricia Tran MD, MS,&nbsp;Samir S. Shah MD, MSCE, MHM,&nbsp;Charlie M. Wray DO, MS","doi":"10.1002/jhm.13455","DOIUrl":"10.1002/jhm.13455","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 10","pages":"962-965"},"PeriodicalIF":2.4,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A beginner's guide to manuscript publication: Getting your paper across the finish line","authors":"Harris Carmichael MD, MSHP,&nbsp;Amy Yu MD,&nbsp;Farah A. Kaiksow MD, MPP,&nbsp;Samir S. Shah MD, MSCE, MHM,&nbsp;Charlie M. Wray DO, MS","doi":"10.1002/jhm.13454","DOIUrl":"10.1002/jhm.13454","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 10","pages":"957-961"},"PeriodicalIF":2.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical student shadowing on hospital medicine direct-care services","authors":"Daniel J. Aldrich MD,&nbsp;Shannon K. Martin MD, MS","doi":"10.1002/jhm.13460","DOIUrl":"10.1002/jhm.13460","url":null,"abstract":"&lt;p&gt;Physician shadowing, or observation of the day-to-day work of a physician, is a time-honored way to introduce students to medical careers and patient care but can be challenging to implement.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Hospital medicine (HM) requires broad expertise in clinical and health systems sciences and provides an opportune environment for valuable and diverse clinical shadowing experiences. Coinciding with HM's growth as a field, HM direct-care services (HM-DCS), or services in which a hospitalist is the sole primary provider, are increasingly utilized in medical education.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The clinical practice of HM, however, is demanding, and some may fear incorporating early learners on HM-DCS may cause greater provider stress, distracting multitasking, and lower productivity.&lt;span&gt;&lt;sup&gt;4-6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;More than ever before, hospitalist educators must navigate tensions between clinical demands and the educational mission.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; A key strategy offered by HM leaders is developing innovative educational opportunities beyond traditional teaching services.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; A well-designed shadowing program can meet this need, and hospitalist educators can excel in creating such programs with a thoughtful approach to design, implementation, and evaluation. Applying Kern's approach to curriculum development and central strategies of implementation science,&lt;span&gt;&lt;sup&gt;10, 11&lt;/sup&gt;&lt;/span&gt; we present a model of preclerkship (i.e., first and second-year medical student) shadowing on HM-DCS at the Pritzker School of Medicine (PSOM) at the University of Chicago Medicine (UCM) that demonstrates how HM-DCS can be successful learning environments for shadowing students while facilitating satisfying teaching opportunities for hospitalists.&lt;/p&gt;&lt;p&gt;Before 2021, PSOM students lacked formal opportunities to shadow in HM. To meet this need, the Section of HM at UCM partnered with PSOM to create an HM-DCS shadowing intervention, or Hospital Medicine Shadowing Experience (HMSE), available to first- and second-year PSOM students and UCM hospitalists.&lt;/p&gt;&lt;p&gt;UCM, a tertiary academic medical center, has 13 general medicine and subspecialty HM-DCS comprising medically and psychosocially complex patients. HM-DCS cap at 11–14 patients and are staffed by approximately 70 hospitalists with varying teaching responsibility levels. Seven-day HM-DCS rotations begin Monday, Wednesday, or Thursday. PSOM, whose campus is adjacent to UCM, has roughly two preclerkship years followed by clinical rotations. Classes are approximately 88 students.&lt;/p&gt;&lt;p&gt;We chose DCS for shadowing students because, unlike traditional teaching services with interns, residents, and other students, they enable a 1:1 apprentice-teacher model, which may allow a more direct interface with patient care and the health system and enhance physician role-modeling and mentorship while not overcrowding traditional teaching services with additional learners.&lt;/p&gt;&lt;p&gt;","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 3","pages":"295-307"},"PeriodicalIF":2.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Your service, our gratitude: A thank you to our peer reviewers","authors":"Samir S. Shah MD, MSCE, MHM,&nbsp;Gregory W. Ruhnke MD, MS, MPH,&nbsp;Sanjay Mahant MD, MSc,&nbsp;Daniel J. Brotman MD,&nbsp;Farah A. Kaiksow MD, MPP,&nbsp;Charlie M. Wray DO, MPH","doi":"10.1002/jhm.13457","DOIUrl":"10.1002/jhm.13457","url":null,"abstract":"&lt;p&gt;The peer review process remains a cornerstone of maintaining the integrity of published research and informs editorial decisions regarding manuscript disposition. Each manuscript receives rigorous evaluation by expert reviewers, who contribute insights on its novelty, originality, scientific validity, and potential impact. These reviewers also offer valuable suggestions for manuscript improvement. This structured review process provides authors with constructive feedback, fosters a sense of community, and facilitates the publication of advancements in research and patient care.&lt;/p&gt;&lt;p&gt;To augment our in-depth editorial assessment, we aim to have at least two independent peer reviews for each manuscript being considered for publication. However, over the past 3 years, we have had increasing difficulty securing reviewers. The average number of invitations we send to receive two quality reviews has increased from four in 2021 to eight this past year. As clinicians and researchers who regularly perform peer reviews for other journals, we understand the challenge of balancing this service with other obligations.&lt;/p&gt;&lt;p&gt;On behalf of the entire journal editorial leadership team, we would like to extend our heartfelt thanks to our peer reviewers. Your reviews significantly enhance our authors' work and we deeply appreciate the time and effort you dedicate to the &lt;i&gt;Journal of Hospital Medicine&lt;/i&gt; community. Your support is essential to our ability to publish such exceptional content.&lt;/p&gt;&lt;p&gt;We would like to highlight some changes we've made to improve our process and your experience as reviewers for the &lt;i&gt;Journal of Hospital Medicine&lt;/i&gt;. We have reduced the demand on our reviewing community. The Editor-in-Chief or other editorial leadership team members assess each manuscript submitted to the journal. This initial screening process has allowed us to only send about 25% of research manuscripts for external peer review. To show our appreciation, our “&lt;i&gt;Journal of Hospital Medicine&lt;/i&gt; Top Reviewer” list recognizes the top 10% of reviewers, a designation awarded based on the combination of the number, quality, and turnaround time of reviews. We encourage recipients to list this honor on their curriculum vitae and share the recognition with their program, division, and department leadership. These contributions should also be highlighted in promotion letters as important service to the field and national acknowledgment of expertise. We also offer continuing medical education credit for peer review, underscoring its value in professional development. As always, we welcome your feedback on our peer review process.&lt;/p&gt;&lt;p&gt;We are committed to building capacity for peer review in hospital medicine. In 2018, we established the &lt;i&gt;Journal of Hospital Medicine&lt;/i&gt; Editorial Fellowship, a year-long mentored experience that helps early career hospitalists develop essential academic skills in peer review, academic writing, and scientific communication.&lt;span&gt;&lt;sup&gt;1, 2","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 1","pages":"3-4"},"PeriodicalIF":2.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141570742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentoring: Shaping the professional identity of the academic internal medicine hospitalist","authors":"Kimberly Bloom-Feshbach MD,&nbsp;Maria Klimenko MD,&nbsp;Kimberly Fluet PhD,&nbsp;Valerie J. Lang MD, MHPE","doi":"10.1002/jhm.13452","DOIUrl":"10.1002/jhm.13452","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We sought to explore how mentoring impacts academic hospitalist professional identity and to elucidate barriers to mentoring in the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted focus groups at three academic medical centers. Informed by social-constructivist theory of identity development, we coded deidentified data and performed thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-one academic hospitalists participated with 1 to &gt;20 years experience. Mentoring shaped professional identity formation in six core domains: choosing academic hospital medicine, identifying and focusing on an area of interest, progressing career, navigating work-life integration, staying in academic medicine, and becoming a mentor. Distinct models included dyadic mentoring, peer mentoring, organic mentoring, and mentoring teams, each with benefits and limitations. We identified nine key mentoring actions that influenced hospitalist professional identity formation and career development. Mentoring barriers included lack of time, awareness, and access to experienced mentors, as well as poor quality mentoring and mentor-mentee malalignment. Aspects of hospitalists' professional identity also posed barriers, including ambivalence around academic identity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1104-1112"},"PeriodicalIF":2.4,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}