Early introduction of the multi-disciplinary team through student Schwartz Rounds: a mixed methodology study

Abstract

Background Medical education has changed continually throughout the covid-19 pandemic, creating additional stress for medical students. Personal reflection can empower an individual to adapt to new challenges, and reflection has gradually become incorporated into medical student training. Schwartz Rounds (SR) offer a compassionate group reflective forum for healthcare staff. SRs have been extensively introduced throughout the NHS, however medical student rounds are yet to be widely adopted. Entirely unresearched is how the multi-disciplinary team impacts a medical student SR. This study aims to compare medical student experience of a single-discipline and a multi-discipline SR using mixed methodology. Methods Two virtual SRs were run at an NHS district general hospital, using the existing structure of the Trust’s rounds. The first round included only medical students on placement at the hospital, whereas the second round also involved other student health disciplines. Following each round Likert scale questionnaires were collected, and focus groups were held with a small number of participants. Quantitative analysis used median averages as well direct comparison of scores for each round. Qualitative data from the focus groups underwent thematic analysis. Results The quantitative data showed a positive response to both styles of student SRs, with over 87% of participants at both rounds stating they intended to attend further rounds. Direct comparison between the two rounds showed higher feedback scores for the single-discipline round. Qualitative analysis showed strong student interest in further group reflection, noting the value of SRs in improving workplace culture and inter-professional relationships. The analysis also highlighted frustrations with the existing SR structure, namely large group sizes and scripted panellists. Conclusions Both data sets showed a strong positive response to SRs, and a desire to attend again. There is some evidence to suggest the addition of multiple student disciplines at SRs impaired medical student reflection. Changes to the format of the round could result in even greater success in student rounds.

Providing compassionate care in a virtual context: Qualitative exploration of Canadian primary care nurses’ experiences

“… 47 Participation in Rounds ® has increased “empathy, compassion, peer support, reflection, work engagement and communication with patients, 47 ” and these are now being delivered virtually. 49 , 50 Rounds ® can be a great platform in which compassionate care could be discussed, particularly when delivered in a virtual context. At a system-level, a unified and integrated system of physical and virtual primary care services is needed to avoid further fragmentation 51 that would create a myriad of incompatible workflows.…”

How Does a Group Reflection Intervention (Schwartz Rounds) Work within Healthcare Undergraduate Settings? A Realist Review

“…That would be incredibly valued, valuable." -RB Student feedback in Abnett et al [42] confirmed that students recognised the benefits from interprofessional learning, gaining greater understanding of other students' roles.…”

“…While Stocker et al [39] and Smith et al [40] reported features atypical for Rounds (mandatory attendance, small group discussion and feedback) we have included them to capture those contextual variations. We have also included two studies on Rounds for healthcare students (exclusively) that took place in clinical settings rather than within a HEI [41,42], as we assessed these to still be highly relevant.…”

“…-FG Corless et al [37] reported one session that received noticeably poorer feedback for the panellists' presentation being too focused on technical content (perhaps being less well-prepared by facilitators). Abnett et al [42] reported some students found polished panellist stories to be intimidating to follow when discussion was handed over to the audience.…”

Case reports, reflective practice and learning to succeed

“…Schwartz rounds are a forum where healthcare staff can listen and engage with their colleagues' personal reflections. They are ultimately designed to facilitate reflection and improve patient experience by supporting and educating healthcare staff [14]. While there is a dearth of evidence that Schwartz Rounds alter practice or patient care, a recent National Institute of Health evaluation identified ‘ripple effects’ in process changes and quality improvement initiatives following their implementation [15].…”