How can we better prepare new doctors for the tasks and challenges of ward rounds?: An observational study of junior doctors’ experiences

Abstract

Purpose: Ward rounds play a crucial role in the delivery of patient care in inpatient settings, but involve a complex mix of tasks, skills and challenges for junior doctors to negotiate. This study informs the development of high-quality training by identifying the activities that junior doctors perform, and those associated with stress during real-life ward rounds. Materials and methods: All activities performed by FY1 doctors (n ¼ 60) over 2 ward rounds were coded in real-time by a trained observer using the work observation method by activity timing (WOMBAT). Doctors' heart rate was continuously recorded and non-metabolic peaks in heart rate used as a physiological indicator of stress. Results: During ward rounds, FY1 doctors commonly engaged in indirect patient care, professional communication, documentation and observation. Very little time was spent on direct patient care (6%) or explicit supervision/education (0.01%). Heart rate data indicated that stress was highest during administrative tasks while interacting directly with patients while stepping out of rounds to complete personal tasks, when answering bleeps and while multi-tasking. Conclusions: Training that specifically covers the activities involved, skills required, and challenges inherent in real-life ward rounds may better prepare FY doctors for this complex area of practice.

Impact of minimally invasive surgery on surgeon health (ISSUE) study: protocol of a single-arm observational study conducted in the live surgery setting

“…The Actiheart 5 monitor (CamNtech) measures 39.7×30.2×9.25 mm, weighs 10.5 g and has a long lasting battery life 31. It has been validated in several studies as an effective tool in measuring heart rate variability as a marker for stress and a psychosocial symptom marker in bio behavioural research 32 33. It will be placed at the centre of the chest, V1 ECG lead position (figure 1), enabling recording of heart rate variability.…”