ISSUES AFFECTING RESIDENTS ATTITUDES ABOUT TELEPHONE MEDICINE FOR AMBULATORY PATIENTS

Background: Telephone medicine is an important component of internists ' practices. Their patients' calls are often complex and lead to furth er medical care. However, telephone medicine skills are seldom taught during internal medicine residencies. Purpose: This study sought to id entify characteristics of residency education and issues important to residents that shape their attitudes about telephone management of amb ulatory patients. Methods: Residents (N = 388) in 10 diverse programs were surveyed confidentially. Responses were grouped into descriptive and attitudinal items and analyzed using factor analysis. Descriptive scales and demographic items were used as independent variables to pre dict attitudinal scales. Results: The residents surveyed expressed dis comfort with telephone medicine. However, they identified receiving pe rformance feedback from a variety of sources, having access to consult ants, having charts available, and documenting calls as important comp onents to their satisfaction with telephone medicine. A predictive mod el for satisfaction with telephone medicine was built (R(2) = .22) usi ng 3 descriptive scales that concerned these aspects of telephone medi cal practice. Conclusions: Several issues were identified as being ass ociated with satisfaction in this important aspect of ambulatory medic al practice, and they should be considered in developing telephone med icine curricula.