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

Abstract

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.

Pediatric Residency Training amid the COVID-19 Pandemic: Exploring the Impact of Supervision and Clinical Practice Guidelines on Clinical and Financial Outcomes

“…Today, experts and leaders want clinical learning methods to return to the bedside round process. Direct supervision (bedside round process) allows residents to develop their skills, practice teamwork, and communicate with patients and all hospital staff for patient-centered care [ 64 ].…”

“…On the other hand, some residents also questioned the benefits of the bedside round learning process and whether bedside rounds could continue to be considered a standard of educational practice. However, almost all residents believe that the learning process at the bedside positively influences resident behavior in providing health care in hospitals [ 64 ]. The supervisor was an effective role model for residents in making complex clinical decisions and allowed them to pursue their preferred plans [ 59 ].…”

“…What is not available in previous papers [1,[60][61][62][63][64][66][67][68][69][70][71][72], is that this paper provides information on the right solution for AMC hospitals forced to experience resource scarcity. The impact of disruption of health services on pediatric patients due to the COVID-19 pandemic in the future must be anticipated, mitigated, and minimized based on valid evidence.…”

“…This research's novelty is quantifying the effect of CPG and supervision on medical services in AMC hospitals by pediatric residents on clinical outcomes and financial outcomes in times of resource scarcity. Previous literatures, which also discussed Supervision and/or CPG [1,[60][61][62][63][64][66][67][68][69][70][71][72] have not calculated how big the "effect size" of Supervision and CPG is on clinical outcomes and financial outcomes in conditions of resource scarcity.…”

The impact of an otolaryngology inpatient consult documentation improvement program

“…Increasing attending presence in the hospital consult setting augments the patient experience, and supplements resident education with direct feedback and teaching related to the patient complaint. 14,15 This conveniently also promotes one of the major pillars/missions of most academic institutions: education. 8 There clearly remain areas for improvement.…”