Effect of Bedside vs. Non-bedside Patient Case Presentation During Ward Rounds: a Systematic Review and Meta-analysis

Gamp, Martina; Becker, Christoph; Tondorf, Theresa; Hochstrasser, Seraina; Metzger, Kerstin; Meinlschmidt, Gunther; Langewitz, Wolf; Schäfert, Rainer; Bassetti, Stefano; Hunziker, Sabina

doi:10.1007/s11606-018-4714-1

Cited by 14 publications

(12 citation statements)

References 21 publications

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“…6,11 The reasons cited for preferring to round away from the bedside vary but include worrying about making a mistake and looking incompetent or about causing patient discomfort; lacking freedom to ask questions and discuss particularities of a clinical case; and having concerns regarding efficiency. [48][49][50] It is encouraging that the results of this review, and others, 19,23 provide evidence that bedside rounds do not negatively affect patients or prolong rounds and may, in fact, improve these outcomes. However, understanding learners' internal reluctance will be important if the educational benefits of bedside rounds are to be fully realized.…”

Section: Favors Br Highmentioning

confidence: 61%

“…Given that previous systematic reviews have reported on the effect of bedside rounds on patient outcomes, we decided not to include studies that reported only patient-level (level 4) outcomes. 19 , 23 We reviewed full-text articles and conference abstracts, regardless of language or date of publication. If there was insufficient information to decide on inclusion, we contacted the study authors for clarification.…”

Section: Methodsmentioning

confidence: 99%

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The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review

et al. 2022

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Purpose To determine if bedside rounds, compared with other forms of hospital ward rounds, improve learning outcomes in medical education. Method For this systematic review, the authors searched Ovid MEDLINE, Embase, and Scopus from inception through February 20, 2020. Experimental studies were included if they (1) compared bedside rounds to any other form of rounds in a hospital-based setting, and (2) reported a quantitative comparison of a learning outcome (e.g., learner reaction, knowledge, skills, behavior, health care delivery) among physicians-in-training (medical students, residents, fellows). Extraction elements were summarized using descriptive statistics and a narrative synthesis of design, implementation, and outcomes. Results Twenty studies met inclusion criteria, including 7 randomized trials. All studies involved resident physicians, and 11 also involved medical students. The design and implementation of bedside rounds varied widely, with most studies (n = 13) involving cointerventions (e.g., staff education, real-time order entry). Of the 15 studies that reported learner satisfaction, 7 favored bedside rounds, 4 favored the control, and 4 were equivocal. Of the 4 studies reporting an outcome of learners’ knowledge and skills, 2 favored bedside rounds and 2 were equivocal. Of the 8 studies that reported on learner behavior (e.g., bedside communication with patients), 5 favored bedside rounds, 1 favored the control, and 2 were equivocal. Finally, of the 14 studies that reported a health care delivery outcome (e.g., teamwork, rounding time), 8 favored bedside rounds and 6 were equivocal. Due to the high risk of bias and unexplained heterogeneity across studies, the overall strength of evidence was low. Conclusions In hospital-based settings, learners’ satisfaction with bedside rounds is mixed. However, bedside rounds appear to have a positive effect on learner behavior and health care delivery. Given their potential value, additional research is needed to identify barriers to and facilitators of educationally successful bedside rounds.

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Section: Favors Br Highmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review

et al. 2022

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“…Although our intervention sought to reshape ICU rounds for the benefit of fellows and residents, we also witnessed an increase in the fellow-nurse and fellow-patient interactions. We did not measure whether these interactions with stakeholders affected their perceptions of rounds, but an immense body of literature supports nurses’, patients’, and families’ receptiveness to rounding models that incorporate bedside teaching and patient-centered care ( 15 , 16 ), including in ICUs ( 17 , 18 ). Thus, increasing bedside interactions between fellows and these stakeholders likely has positive effects on communication among stakeholders ( 15 – 17 ) without sacrificing the educational value of rounds ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Fellows-as-Teachers Workshops on Teaching Rounds: An Observational Study in an ICU

Franco

Patel

Khan

et al. 2020

Critical Care Explorations

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“…In theory, this process allows for information sharing between patients and physicians, which can promote shared decision-making and improve outcomes. However, despite the intuitive benefit of bedside rounds, recent systematic reviews have shown that bedside rounds, compared to other forms of ward rounds, appears to have a no meaningful impact on patient-centered outcomes (14,15).…”

Section: Introductionmentioning

confidence: 99%

Relationships Between Time-at-Bedside During Hospital Ward Rounds, Clinician–Patient Agreement, and Patient Experience

Ratelle

Herberts

Miller

et al. 2021

Journal of Patient Experience

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Hospital medicine ward rounds are often conducted away from patients’ bedsides, but it is unknown if more time-at-bedside is associated with improved patient outcomes. Our objective is to measure the association between “time-at-bedside,” patient experience, and patient–clinician care agreement during ward rounds. Research assistants directly observed medicine services to quantify the amount of time spent discussing each patient’s care inside versus outside the patient’s room. “Time-at-bedside” was defined as the proportion of time spent discussing a patient’s care in his or her room. Patient experience and patient–clinician care agreement both were measured immediately after ward rounds. Results demonstrated that the majority of patient and physicians completely agreement on planned tests (66.3%), planned procedures (79.7%), medication changes (50.6%), and discharge location (66.9%), but had no agreement on the patient’s main concern (74.4%) and discharge date (50.6%). Time-at-bedside was not correlated with care agreement or patient experience ( P > .05 for all comparisons). This study demonstrates that spending more time at the bedside during ward rounds, alone, is insufficient to improve patient experience.

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Effect of Bedside vs. Non-bedside Patient Case Presentation During Ward Rounds: a Systematic Review and Meta-analysis

Cited by 14 publications

References 21 publications

The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review

The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review

Impact of Fellows-as-Teachers Workshops on Teaching Rounds: An Observational Study in an ICU

Relationships Between Time-at-Bedside During Hospital Ward Rounds, Clinician–Patient Agreement, and Patient Experience

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