The educational value of ward rounds for junior trainees.
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ABSTRACT:
SUBMITTER: Laskaratos FM
PROVIDER: S-EPMC4408315 | biostudies-literature | 2015
REPOSITORIES: biostudies-literature
Publications
The educational value of ward rounds for junior trainees.
Laskaratos Faidon-Marios FM Wallace Deirdre D Gkotsi Despoina D Burns Aine A Epstein Owen O
Medical education online 20150421
The ward round (WR) is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality o ...[more]
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Project description:BackgroundWard rounds are a cornerstone in the educational experience of junior doctors and an essential part of teaching patient care. Here, we aimed to assess the doctors' perception of ward rounds as an educational opportunity and to identify the obstacles faced in conducting a proper ward round in Sudanese hospitals.MethodA cross-sectional study was conducted from the 15th to the 30th of January 2022 among house officers, medical officers, and registrars in about 50 teaching and referral hospitals in Sudan. House officers and medical officers were considered the learners, while specialist registrars were considered the teachers. Doctors' perceptions were assessed using an online questionnaire, with a 5-level Likert scale to answer questions.ResultsA total of 2,011 doctors participated in this study (882 house officers, 697 medical officers, and 432 registrars). The participants were aged 26.9 ± 3.2 years, and females constituted about 60% of the sample. An average of 3.1 ± 6.8 ward rounds were conducted per week in our hospitals, with 11.1 ± 20.3 h spent on ward rounds per week. Most doctors agreed that ward rounds are suitable for teaching patient management (91.3%) and diagnostic investigations (89.1%). Almost all the doctors agreed that being interested in teaching (95.1%) and communicating appropriately with the patients (94.7%) make a good teacher in ward rounds. Furthermore, nearly all the doctors agreed that being interested in learning (94.3%) and communicating appropriately with the teacher (94.5%) make a good student on ward rounds. About 92.8% of the doctors stated that the quality of ward rounds could be improved. The most frequently reported obstacles faced during ward rounds were the noise (70%) and lack of privacy (77%) in the ward environment.ConclusionWard rounds have a special value in teaching patient diagnosis and management. Being interested in teaching/learning and having good communication skills were the two major criteria that make a good teacher/learner. Unfortunately, ward rounds are faced with obstacles related to the ward environment. It is mandatory to ensure the quality of both ward rounds' teaching and environment to optimize the educational value and subsequently improve patient care practice.
| S-EPMC10248958 | biostudies-literature
Project description:ObjectivesTo ascertain parental views regarding taking part in neonatal unit ward rounds.DesignA service evaluation project.SettingTertiary neonatal intensive care unit.PatientsParent(s) of infants receiving care on the neonatal unit.InterventionsStructured interviews conducted at the cot side.Main outcome measuresParents were asked if they knew when ward rounds occurred, whether they had attended ward rounds and if they had not what were the factors inhibiting them from doing so, their experience of attending ward rounds and whether they were concerned about issues of confidentiality.Results23 of 24 consecutive parents agreed to be interviewed. The median age of their infants was 14 (range 3 - 123) days when they were interviewed. Eighty-five per cent were able to identify when a nursing handover or doctor's ward round occurred. Seventy-five per cent of parents had attended at least one ward round and the median score in terms of usefulness was 5 out of 5. Reasons for not attending included time and cost to travel to the unit, their partners were working and having other children. Parents volunteered that the nurses proactively updated them as soon as they arrived, hence making regular attendance less important. Regarding confidentiality, 85% were not concerned if other people overheard information about their baby, unless the news was bad.ConclusionsParents recognised the value of attending ward rounds and generally found it a positive experience, but emphasised limitations on their ability to attend.
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Project description:IntroductionPalliative care is essential for patients with terminal diseases and aims at effective symptom control. This may stand in opposition to radiation treatment as an oncological treatment modality. The hereby presented work demonstrates the successful integration of a palliative care service in the radiation oncology ward.MethodsSince 2015, 1018 patients were seen by the palliative care service on the radiation oncology ward and have been analyzed in this single center study. To assess teaching efficacy of the consultation service, a survey was conducted among 15 radiation oncology residents.ResultsCooperation between the two departments proved to be efficient with rising patient numbers. Palliative care was able to guide appropriate postdischarge care with the number of patients dying on the radiation oncology ward decreasing significantly (p = 0.009). The main topics for consultation were pain medication (92.3%), organization of postdischarge care (92.3%), and psycho-oncological support (84.6%). Most residents had a positive image of the palliative care service and consented on adjectives like "enriching", "empathic", "collegial", "professionally founded", and a "low threshold for consultation". All participants agreed that cooperation deepened their knowledge on palliative care.ConclusionA synergistic cooperation between a palliative care consultation service and a radiation oncology department addresses patient symptoms on an individual level. It confers advanced knowledge on palliative care which is essential for resident education and patient treatment.
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Project description:BackgroundWard rounds form an integral part of Internal Medicine teaching. This study aimed to determine the trainees' opinions regarding various aspects of their ward rounds, including how well they cover their learning needs, how they would like the rounds to be conducted, and differences of opinion between medical students and postgraduates.MethodsA cross-sectional study was conducted on a total of 134 trainees in Internal Medicine, comprising medical students, interns, residents and fellows, who were asked to fill in a structured, self-designed questionnaire. Most of the responses required a rating on a scale of 1-5 (1 being highly unsatisfactory and 5 being highly satisfactory).ResultsTeaching of clinical skills and bedside teaching received the lowest overall mean score (Mean +/- SD 2.48 +/- 1.02 and 2.49 +/- 1.12 respectively). They were rated much lower by postgraduates as compared to students (p < 0.001). All respondents felt that management of patients was the aspect best covered by the current ward rounds (Mean +/- SD 3.71 +/- 0.72). For their desired ward rounds, management of patients received the highest score (Mean +/- SD 4.64 +/- 0.55), followed by bedside examinations (Mean +/- SD 4.60 +/- 0.61) and clinical skills teaching (Mean +/- SD 4.50 +/- 0.68). The postgraduates desired a lot more focus on communication skills, counselling and medical ethics as compared to students, whose primary focus was teaching of bedside examination and management. A majority of the respondents (87%) preferred bedside rounds over conference room rounds. Even though the duration of rounds was found to be adequate, a majority of the trainees (68%) felt there was a lack of individual attention during ward rounds.ConclusionsThis study highlights important areas where ward rounds need improvement in order to maximize their benefit to the learners. There is a need to modify the current state of ward rounds in order to address the needs and expectations of trainees.
| S-EPMC2912319 | biostudies-literature
Project description:BackgroundTo prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surgeons of the 25 most viewed laparoscopic appendectomy videos listed on YouTube. Additionally, we assessed the video conformity to the published guidelines on how to report laparoscopic surgery videos (LAP-VEGaS).MethodsBased on the number of visualization, the 25 most viewed videos on laparoscopic appendectomy uploaded on YouTube between 2010 and 2018 were selected. Videos were evaluated on the surgical technical performance (GOALS score), critical view of safety (CVS), and overall video quality and utility.ResultsVideo image quality was poor for nine (36%) videos, good for nine (36%), and in high definition for seven (28%). Educational content (e.g., audio or written commentary) was rarely present. With the exception of the overall level of difficulty, poor consistency was observed for the GOALS domains between senior surgeons and trainees. Fifteen videos (60%) demonstrated a satisfactory CVS score (≥ 5). Concerning the overall video quality, agreement among senior surgeons was higher (Cronbach's alpha 0.897) than among trainees (Cronbach's alpha 0.731). The mean overall videos utility (Likert scale, 1 to 5) was 1.92 (SD 0.88) for senior examiners, and 3.24 (SD 1.02) for trainee examiners. The conformity to the LAP-VEGaS guidelines was weak, with a median value of 8.1% (range 5.4-18.9%).ConclusionLaparoscopic videos represent a useful and appropriate educational tool but they are not sufficiently reviewed to obtained standard quality. A global effort should be made to improve the educational value of the uploaded surgical videos, starting from the application of the nowadays-available LAP-VEGaS guidelines.
| S-EPMC6507219 | biostudies-literature
Project description:ObjectiveThe purpose of this study was to develop a standardized rounding tool for use on the general paediatric ward and to determine if its use can improve quality of rounds as well as patient and parent satisfaction.MethodologyThe study used a pre- and post-intervention prospective observational methodology. The intervention consisted of the implementation of a Checklist Rounding Tool (CRT) entitled the 'Paediatric Inpatient Rounding Checklist (PIRC)' which outlined items deemed essential to discuss during rounds for all patients admitted to the paediatric ward. The PIRC was created by the research team after reviewing the literature and it was peer reviewed by a panel of expert paediatricians. Performance on rounds based on discussion of checklist items as well as patient and parent satisfaction were evaluated by an external observer both pre- and post-PIRC implementation.ResultsFour of the five less frequently addressed checklist items were discussed significantly more post-intervention. The Rounds Quality Score was significantly improved after checklist implementation, the pre- and post-intervention scores being 8.24 and 9.61/10, respectively (P-value <0.001). Patient and parent satisfaction were rated higher with the use of the checklist. There was no difference in the duration of rounds between the pre- and post-implementation phases.ConclusionIn summary, utilization of a standardized rounding tool on an inpatient paediatric ward led to improvement in quality of rounds as well as patient and parent satisfaction.
| S-EPMC9113846 | biostudies-literature
Project description:IntroductionClinical pharmacists' participation in ward rounds (WRs) has been a great chance to contribute to team-based care in the hospital setting and significantly improve patient outcomes and quality of life. Hence, the objective of this investigation was to explore the perceptions of clinical pharmacists in Yemen regarding their participation in WRs and the factors influencing their involvement.MethodsAn online survey of Yemeni clinical pharmacists was conducted and lasted for two months. Descriptive statistics were used to analyse the survey responses.Resultsa total of 120 participants were involved. About 3 out of 10 pharmacists had not previously participated in WRs, with only 30% having always or most of the time participated in word rounds alongside physicians. The results showed a positive perception of WR participation, with a median and IQR of 5(4-5). However, a lack of awareness of WR roles and the time-consuming nature of participation were the reasons for non-involvement.ConclusionThe study highlights the positive perceptions of Yemeni clinical pharmacists towards ward rounds, but emphasises the need to address awareness and time constraints. Emphasising patient-centered care and longer internship durations can improve clinical pharmacist involvement. Future research should focus on optimising clinical pharmacist participation for better patient outcomes and care quality.
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Project description:Objectives: Ward rounds serve a crucial daily activity in hospitals. Building on the Entrustable Professional Activity "Conducting internal medicine ward rounds" consisting of ten competencies and 25 corresponding activities, this study aims at assessing content and external validity of an observation checklist for this EPA. Methods: A focus group aimed at content validation of the checklist. Five participants therefore evaluated it with respect to comprehensiveness and comprehensibility. To investigate external validity, 14 authentic ward rounds were video-taped and rated by two raters with the adapted observation checklist in terms of the appearance of certain activities in the videos. Results: After some adaptions, participants of the focus group agreed on a checklist consisting of nine competencies, 25 activities and 110 examples of observable behaviours supporting content validity. External validity was studied by using the observation checklist for ratings of ward round videos. The checklist was regarded as a valuable tool to structure observation. Along with the high frequencies of observed behaviour and interrater-reliability, external validity can be assumed. Conclusion: The first scientifically developed comprehensive observation checklist for the EPA conducting a ward round in internal medicine is presented. The checklist is a valuable tool for providing elaborated feedback in undergraduate and graduate medical education. Focussing on multi-institutional validation and the cut offs of the checklist to determine the levels of entrustment are recommended for future research.
| S-EPMC6022584 | biostudies-literature
Project description:The priority to ensure patient safety and use resources effectively, demands attention and innovation. Video enhanced reflective practice (VERP) provides training based upon analysis of film clips of one's professional practice to develop practical insight into the processes of communication, so that effective changes can be made to ongoing behaviour and practice. In this case the focus was on multi-disciplinary communication within daily board rounds on an acute medicine and care of the elderly ward. Baseline assessment and post intervention testing of perceptions of change by both full and core team were undertaken to establish the impact of VERP training. In addition pre and post focus group discussion and film analysis supplemented evaluation. The findings support the view that after VERP training of a core team, board rounds were seen as consistently easier to participate in, providing improved focus, were more efficient in goal setting and resulting in better care for patients as well as improved pathways to discharge. This suggests benefits to the communication "culture" of a multidisciplinary team resulting in increased benefits for the wider team. It is concluded that the use of tailored VERP training for personal, professional and team development is relevant, feasible, and worthy of further testing and investigation.
| S-EPMC4645856 | biostudies-other
Project description:Family-centered rounding (FCR) allows the medical team to partner with patients in medical decision-making, improving communication, and enhancing safety. However, FCR may compromise aspects of the resident education experience. In a survey of pediatric residents at our children's hospital, only 20% felt FCR provided the best educational experience. We designed this project to increase the percentage of residents with a positive perception of the educational experience on FCR from 20% to 80% in 6 months.MethodsThis project utilized The Model for Improvement and sequential plan-do-study-act cycles. A needs assessment identified educational activities negatively impacted by FCR. We then designed a hybrid FCR process with formal presentations outside patient rooms followed by traditional bedside FCR. Our primary measure was the percentage of residents positively perceiving the FCR educational experience. Our balancing measures included rounding duration and family satisfaction and comprehension.ResultsResidents who perceive FCR to be the best educational experience improved from a baseline of 21% to 76%, with a calculated response rate of 79%. Patients receiving FCR remained above 80%. All surveyed families understood their care plans and remained satisfied with the information provided, although 21% were concerned about the number of people present on rounds during the COVID-19 pandemic. Forty-three percent of hospitalist rounds exceeded the allotted time.ConclusionsThe hybridization of FCR to include formal presentations may improve the resident learning experience while preserving family satisfaction and comprehension.
| S-EPMC9622666 | biostudies-literature