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Shaik T, Aggarwal K, Singh B, Sawhney A, Naguluri R, Jain R, Jain R. A comprehensive analysis of different types of clinical rounds in hospital medicine. Proc AMIA Symp 2023; 37:135-141. [PMID: 38173995 PMCID: PMC10761014 DOI: 10.1080/08998280.2023.2261086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/15/2023] [Indexed: 01/05/2024] Open
Abstract
Table rounds and bedside rounds are two methods healthcare professionals employ during clinical rounds for patient care and medical education. Bedside rounds involve direct patient engagement and physical examination, thus significantly impacting patient outcomes, such as improving communication and patient satisfaction. Table rounds occur in a conference room without the patient present and involve discussing patient data, which is more effective in fostering structured medical education. Both bedside and table rounds have pros and cons, and healthcare professionals should consider the specific requirements of their patients and medical trainees when deciding which approach to use. This research utilized a comprehensive search to identify relevant resources, such as university website links, as well as a PubMed search using relevant keywords such as 'bedside rounding,' 'table rounding,' and 'patient satisfaction.' Relevance, publication date, and study design were the basis for inclusion criteria. This study compared the effectiveness of these two methods based on physician communication, medical education, patient care, and patient satisfaction.
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Affiliation(s)
- Tanveer Shaik
- Avalon University School of Medicine, Willemstad, Curacao
| | | | | | - Aanchal Sawhney
- Department of Internal Medicine, Crozer Chester Medical Center, Upland, Pennsylvania, USA
| | - Riya Naguluri
- Great Valley High School, Malvern, Pennsylvania, USA
| | - Rohit Jain
- Avalon University School of Medicine, Willemstad, Curacao
| | - Rahul Jain
- Avalon University School of Medicine, Willemstad, Curacao
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Noorani M. The ward round: friend or foe in postgraduate training? A grounded theory study of residents' perspectives. MEDICAL EDUCATION ONLINE 2022; 27:2101180. [PMID: 35850579 PMCID: PMC9302005 DOI: 10.1080/10872981.2022.2101180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/23/2022] [Accepted: 07/10/2022] [Indexed: 06/10/2023]
Abstract
The ward round has traditionally been a learning activity in medical education. Apart from education, ward rounds have multiple roles including patient care and communication. Some studies have described the ward round as an ideal place to learn patient management while others reported that little learning happens on rounds due to lack of time and patient volume. This study aimed to develop a deeper understanding of ward round learning from the perspective of postgraduate trainees. A constructivist grounded theory approach was used and data was collected during focus group discussions. Data were analyzed by initial coding, then grouped into focused codes and development of a theoretical framework by the process of constant comparison. Six categories evolved which contributed to the framework. Postgraduate trainees perceive the ward round as an important space where they use different learning activities to acquire knowledge, attitude and skills required of a specialist doctor. They progress from novices to experts under supervision of faculty who lead ward rounds. The round can achieve its full learning potential if planned and organized well but can become a missed opportunity if the learning environment is unfriendly. Patient- and learner-related barriers exist that hinder ward round learning. The framework explains how ward round learning occurs in postgraduate medical education from a trainee perspective. The findings can guide interventions to improve the learning experience. Studies comparing perspectives of teachers to those of learners are needed to further understand the complex learning milieu of the ward round.
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Affiliation(s)
- Mariam Noorani
- Consultant Paediatrician and Senior Instructor Department of Paediatrics, Aga Khan University, Dar Es Salaam, Tanzania
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Ohta R, Sano C. Bedside Teaching in Rural Family Medicine Education in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116807. [PMID: 35682389 PMCID: PMC9180610 DOI: 10.3390/ijerph19116807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022]
Abstract
Bedside teaching is essential in family medicine education so that residents may learn about various clinical conditions and develop professional skills. In particular, bedside teaching is useful in a rural context because rural family medicine deals with a broad scope of biopsychosocial problems among older patients. Accordingly, based on an inductive thematic analysis, we propose a framework for bedside teaching in rural family medicine education, which consists of four themes: accommodation of different learners, near-peer learning, the change in engagement of medical teachers in bedside teaching, and driving interpersonal collaboration. Bedside teaching can promote interactions between different medical learners. Near-peer learning in bedside teaching compensates for the limited availability of educators and improves learners’ motivation for self-directed learning. Through bedside teaching, medical learners can observe each other and provide constructive feedback, thereby improving their relationships and learning. For effective bedside teaching, medical educators should facilitate learners and collaborate with other medical professionals. Additionally, bedside teaching should accommodate a variety of learners, facilitate near-peer and self-directed learning, educators’ involvement based on cognitive apprenticeship, along with interprofessional collaboration with nurses. Interprofessional collaboration between rural family medicine teachers, learners, and nurses may improve the quality of patient care due to the increased understanding between patients and other medical staff in hospitals.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan 699-1221, Japan
- Correspondence: ; Tel.: +81-90-5060-5330
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Japan;
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Sweigart JR, Lippert WC, Atkinson HH, Hall AM, Nichani S, Ragsdale JW, Russell GB, Lichstein PR. Impact of Bedside Rounding on Attending Teaching Evaluations. South Med J 2022; 115:139-143. [PMID: 35118504 DOI: 10.14423/smj.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine associations between bedside rounding (BSR) and other rounding strategies (ORS) with resident evaluations of teaching attendings and self-reported attending characteristics. METHODS Faculty from three academic medical centers who attended resident teaching services for ≥4 weeks during the 2018-2019 academic year were invited to complete a survey about personal and rounding characteristics. The survey instrument was iteratively developed to assess rounding strategy as well as factors that could affect choosing one rounding strategy over another. Survey results and teaching evaluation scores were linked, then deidentified and analyzed in aggregate. Included evaluation items assessed resident perceptions of autonomy, time management, professionalism, and teaching effectiveness, as well as a composite score (the numeric average of each attending's scores for all of the items at his or her institution). BSR was defined as spending >50% of rounding time in patients' rooms with the team. Hallway rounding and conference room rounding were combined into the ORS category and defined as >50% of rounding time in these settings. All of the scores were normalized to a 10-point scale to allow aggregation across sites. RESULTS A total of 105 attendings were invited to participate, and 65 (62%) completed the survey. None of the resident evaluation scores significantly differed based on rounding strategy. Composite scores were similar for BSR and ORS (difference of <0.1 on a 10-point scale). Spearman correlation coefficients identified no statistically significant correlation between rounding strategy and evaluation scores. An exploratory analysis of variance model identified no single factor that was significantly associated with composite teaching scores (P > 0.45 for all) or the domains of teaching efficacy, professionalism, or autonomy (P > 0.13 for all). Having a formal educational role was significantly associated with better evaluation scores for time management, and the number of lectures delivered per year approached statistical significance for the same domain. CONCLUSIONS Conducting BSR did not significantly affect resident evaluations of teaching attendings. Resident perception of teaching effectiveness based on rounding strategy should be neither a motivator nor a barrier to widespread institution of BSR.
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Affiliation(s)
- Joseph R Sweigart
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - William C Lippert
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - Hal H Atkinson
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - Alan M Hall
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - Satyen Nichani
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - John W Ragsdale
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - Gregory B Russell
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
| | - Peter R Lichstein
- From the Lexington VA Health Care System, Lexington, Kentucky, the Wake Forest School of Medicine, Winston-Salem, North Carolina, the University of Kentucky College of Medicine, Lexington, and the University of Michigan Medical School, Ann Arbor
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Ricotta DN, Freed JA, Hale AJ. Things We Do for No Reason™: Card Flipping Rounds. J Hosp Med 2020; 15:498-501. [PMID: 32118567 DOI: 10.12788/jhm.3374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/17/2019] [Indexed: 11/20/2022]
Abstract
Inspired by the ABIM Foundation's Choosing Wisely® campaign, the "Things We Do for No Reason™" (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent "black and white" conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.
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Affiliation(s)
- Daniel N Ricotta
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Carl J. Shapiro Institute for Education and Research, Boston, Massachusetts
| | - Jason A Freed
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Andrew J Hale
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont
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