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Background: At academic medical centers, children are cared for by large medical teams consisting of multi-level learners including medical students, interns, senior residents and fellows on patient-and family-centered rounds (PFCR). The size and structure of these teaching teams can make it difficult for patients and families to know who is caring for them and establish a trusting relationship. Also, research has shown when residents are perceived as a “team leader,” they learn more. Previous literature in adults has shown that patients often perceive the intern as their “main doctor,” but this has not been studied in pediatrics. Objective: We sought to identify who caregivers identify as their child’s main doctor and recorded the frequency of caregivers who identified the presenter (medical student or intern) as their child’s main doctor. Additionally, we described the frequency of caregivers who were aware that their child was going to be cared for by a large team of doctors at different levels of training. Methods: We conducted a single-institution prospective cohort study using a convenience sample of caregivers admitted to the hospital on pediatric hospital medicine teaching teams that conduct PFCR. After a rounding encounter, we surveyed caregivers who speak English or Spanish. Masked photos of all team members were provided to caregivers when asked to identify the child’s main doctor and the leader of the team. For each patient with permission from the caregiver, we recorded the number of prior admissions, active consultants during the current admission, and number of complex chronic care conditions. Results: A total of 99 patient caregivers were surveyed. Patient demographics are listed below: 46% of respondents did not know their child would be cared for by a large team of doctors, and 43% of respondents did not know learners would be involved in their child’s care. Graphs below indicate who caregivers selected as their main doctor, and in charge of their child’s care team. Discussion: In this study, caregivers varied in who they thought was their child’s main doctor and the leader of their child’s care team. Most were unaware that large medical teams with learners at different levels of their training would care for their child. Work can be done to better orient families and caregivers to teaching teams. This could include a standardized introduction process on admission within each hospital system.




Presented at the Pediatric Academic Societies (PAS) 2023 Meeting; Washington, D.C.; April 27-May 1, 2023.

Who’s my child’s main doctor?​ Caregiver Perceptions of Teaching Teams

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