Sitting at the Bedside: Patient and Internal Medicine Trainee Perceptions

Link to article at PubMed

J Gen Intern Med. 2022 Jan 10:1-7. doi: 10.1007/s11606-021-07231-4. Online ahead of print.

ABSTRACT

BACKGROUND: Sitting at the bedside may strengthen physician-patient communication and improve patient experience. Yet despite the potential benefits of sitting, hospital physicians, including resident physicians, may not regularly sit down while speaking with patients.

OBJECTIVE: To examine the frequency of sitting by internal medicine residents (including first post-graduate year [PGY-1] and supervising [PGY-2/3] residents) during inpatient encounters and to assess the association between patient-reported sitting at the bedside and patients' perceptions of other physician communication behaviors. We also assessed residents' attitudes towards sitting.

DESIGN: In-person survey of patients and email survey of internal medicine residents between August 2019 and January 2020.

PARTICIPANTS: Patients admitted to general medicine teaching services and internal medicine residents at The Johns Hopkins Hospital.

MAIN MEASURES: Patient-reported frequency of sitting at the bedside, patients' perceptions of other communication behaviors (e.g., checking for understanding); residents' attitudes regarding sitting.

KEY RESULTS: Of 334 eligible patients, 256 (76%) completed a survey. Among these 256 respondents, 198 (77%) and 166 (65%) reported recognizing the PGY-1 and PGY-2/3 on their care team, respectively, for a total of 364 completed surveys. On most surveys (203/364, 56%), patients responded that residents "never" sat. Frequent sitting at the bedside ("every single time" or "most of the time," together 48/364, 13%) was correlated with other positive behaviors, including spending enough time at the bedside, checking for understanding, and not seeming to be in a rush (p < 0.01 for all). Of 151 residents, 77 (51%) completed the resident survey; 28 of the 77 (36%) reported sitting frequently. The most commonly cited barrier to sitting was that chairs were not available (38 respondents, 49%).

CONCLUSIONS: Patients perceived that residents sit infrequently. However, sitting was associated with other positive communication behaviors; this is compatible with the hypothesis that promoting sitting could improve overall patient perceptions of provider communication.

PMID:35013927 | PMC:PMC8744572 | DOI:10.1007/s11606-021-07231-4

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