Bibliographic record
Abstract
PURPOSE: During admission case review, teams work to develop a shared understanding of the problems they need to address during the patient's hospitalization. However, research on the effects of the case review on patient care is limited. Informed by rhetorical genre theory, the authors explored the impact of team's communication practices on the comprehensiveness of the case review. METHOD: Using a multiple-case-study approach, the authors in 2010 observed in person, audio-recorded, and transcribed data from overnight and morning case review discussions for 19 patient cases in the internal medicine department of an academic medical center. They also extracted data from the corresponding admission notes. They used a constant-comparison approach to identify emerging themes within and across cases. RESULTS: The authors identified detours, which typically arose from supervisors' interruptions, in all 19 cases. They identified five detour types: pausing the presentation, referring to a section later in the presentation, presenting sections out of sequence, skipping a section, and truncating the presentation. Although supervisors' interruptions during case review discussions allowed for teaching and patient care, they also created detours from the usual case presentation, which then could lead to the omission of relevant case details. CONCLUSIONS: Supervisors' interruptions during case review discussions can lead to detours, which simultaneously afford valuable opportunities for teaching and threaten comprehensive information sharing. Future research should explore detours in other teaching settings to better understand their positive, negative, and unintended consequences for patient care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".