Schwartz Centre Rounds: a new initiative in the undergraduate curriculum—what do medical students think?

Abstract

BackgroundTraining to be a doctor and caring for patients are recognized as being stressful and demanding. The wellbeing of healthcare professionals impacts upon the wellbeing and care of patients. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance communication and compassion, and have since been widely adopted as a way of fostering compassion. The continuum of education suggests that medical students need to develop these attributes in conjunction with resilience and maintaining empathy. The benefits of SCRs in fostering this development in medical students is unexplored.The objective of this study was to examine the potential of SCRs within the undergraduate curriculum.MethodsTwo student–focused SCRs were piloted at a major medical school. The sessions were based on the current format implemented across the US and UK: a presentation of cases by a multidisciplinary panel followed by an open discussion with the audience. Participants were asked to complete an evaluative questionnaire immediately following the sessions. Seven students took part in a focus group to explore their views on the SCR. Data sets were examined using descriptive statistics and thematic analysis.ResultsFeedback was obtained from 77 % (258/334) Year 5 and 37 % (126/343) Year 6 students. Mean student ratings of the session on a five-point scale, where 1 = poor and 5 = exceptional, were 3.5 (Year 5) and 3.3 (Year 6). Over 80 % of respondents either agreed or strongly agreed that the presentation of cases was helpful and gave them insight into how others feel/think about caring for patients. Eighty percent said they would attend a future SCR and 64 % believed SCRs should be integrated into the curriculum. Focus group participants felt SCRs promoted reflection and processing of emotion. Students identified smaller group sizes and timing in the curriculum as ways of improving SCRs.ConclusionStudents were positive about SCRs, preferring them to their current reflective practice assignments. Whether this results in sustained benefits to trainee doctors is yet to be explored. Consideration is given to overcoming the challenges that were encountered, such as optimal timing and participation. Staff training and costs are potential obstacles to adoption.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0762-6) contains supplementary material, which is available to authorized users.

Medical students’ experiences with goals of care discussions and their impact on professional identity formation

“…86,87 Small group, facilitated discussions to provide learners 'opportunities to engage in active sense-making activities' 88 and discuss their experiences with end-of-life care may promote such professional growth. Examples of such interventions in medicine include Schwartz Centre Rounds 89,90 and Balint groups. 91,92 Near-peer-led small group sessions might be particularly helpful to facilitate discussion through reflective storytelling and prepare learners for negative role models.…”

Introducing compassion into the education of health care professionals; can Schwartz Rounds help?

“…Qualitative free text comments were left on post it notes and a focus group was held with attendees 10 days after the first Round. Results from the pilot [3,26] show that 80 % (292/365) of students said they would attend a future SCR and 64 % (235/366) thought that SCR should be integrated into the medical school curriculum. Similarly, 81 % of students either agreed or strongly agreed that the presentation of cases were helpful and gave them insight into how others feel/think about caring for patients.…”

“…This paper explores how Schwartz Rounds may be incorporated into the standard curriculum of health care students to help students to engage in more compassionate, open patterns of communication and care -both with colleagues and patients. Data from a pilot project [3] at University College London Medical School (UCLMS) where Schwartz Rounds are now being run with years 5 and 6 medical students will be drawn on. …”

Clinical Debrief: learning and well‐being together

“…Considering SCRs, Gishen states ‘there is no standard model for the “what” “when” or “how” SCRs might be conducted within a training environment, nor any indication of how sustainable such initiatives would be’ . We have demonstrated the delivery of Clinical Debrief, at scale, in a manner that we believe to be sustainable.…”

“…Ishak reports stress reduction with peer support around difficult cases . Gishen describes Shwartz Centre Rounds (SCRs) as fostering undergraduate compassion . We have developed a model of psychological supervision for our students integrated with case‐based learning of clinical reasoning: Clinical Debrief.…”