Educational tool for hospital-based training in family medicine.

Hospitalists are educators in many teaching institutions throughout North America, and they are a vital part of the medical training system. In Canada, this role is not yet clearly defined, as 90% of practising hospitalists are trained as family medicine specialists.1 Once they begin working as hospitalists, it becomes unclear whether they are teaching internal medicine or family medicine in a hospital setting when they are assigned students. In addition, most universities have not set up full medical teaching units for hospitalist services in the same way they have with general or specialty internal medicine. Now that the College of Family Physicians of Canada’s Triple C curriculum includes a call for training by family medicine doctors,2 there is a new opportunity for innovative teaching for inpatient care, both by family medicine hospitalists and family medicine physicians who maintain acute care practices. Education of students and residents is a timeconsuming but necessary and rewarding part of employment in a teaching hospital. In Calgary, Alta, all hospitalists were asked to be part of a new mandate in the Department of Family Medicine incorporating the Triple C curriculum; the goal was to have most of the residency teaching done by practising family medicine physicians. In this regard, hospitalist practitioners presented a unique opportunity to have many “care of the adult” learning objectives taught within hospitalist services. Thus, a 1-month rotation was rolled out in 3 sites to allow for more teaching to be representative of the model of practice that family medicine residents might seek after graduation. This led to a number of hospitalist physicians being called on to provide family medicine residents with more one-on-one teaching. The goal is for these trainees to become self-directed, mature learners as part of their CanMEDS–Family Medicine (CanMEDS-FM) competencies.3 In 2008, my development of a teaching tool coincided with the move to direct more residents into core block rotations on the hospitalist service. This tool was designed and pilot-tested even before formal rotations at the Peter Lougheed Centre of the Calgary General Hospital. The goal of its use was to enhance the ability of teachers to guide resident learning for clinical case-based teaching, and to encourage students to develop self-directed learning skills. Since its development, this tool has been modified to embody the Triple C concept of comprehensive care that is centred in family medicine and built around CanMEDS-FM roles.