Ward round competences in surgery and psychiatry - a comparative multidisciplinary interview study

Abstract

Background The ward round is a key element in everyday hospital inpatient care irrespective of the medical speciality. The underperformance in conducting ward rounds of junior clinicians has already been described. Therefore, necessary skills and competences of clinicians need to be defined, taught and delivered for curricular instruction. In addition to published data on ward round competences in internal medicine this study aims to determine the common competences for surgical and psychiatric ward rounds in order to find differences depending on the speciality. Methods Semi-structured interviews with surgical ( N = 30) and psychiatric ward staff ( N = 30) of a university hospital and five community hospitals were conducted. Competences necessary for performing ward rounds as well as structural aspects were identified by systematic content analysis and frequency analysis, supported by adequate statistics. Results Relevant competences for both fields are: collaborative clinical reasoning, communication with the patient and the team, organization, teamwork, management of difficult situations, self-management, error-management, teaching, empathy, nonverbal communication, patient-management and professionalism . Clinical skills were mentioned more often in surgical interviews, while nonverbal communication was described more often in psychiatric interviews. Empathy and communication with the team were more frequently attributed to psychiatric residents. Conclusion The competences which were identified as necessary for conducting a ward round in surgery and psychiatry are similar and correspond to previously reported competences in internal medicine. Clinical skills are of greater importance in surgery than in psychiatry. Concerning empathy and nonverbal communication , further research is needed to determine whether they are of minor importance in surgery or whether there is a lack of awareness of these competences. Electronic supplementary material The online version of this article (10.1186/s12909-019-1554-6) contains supplementary material, which is available to authorized users.

Nursing and medical students’ experiences of interprofessional education during clinical training in psychiatry

“…Round school is an example of how IPE can be integrated into the units' regular ward rounds. An important aspect of IPC during rounds is the ability to prepare, organize, communicate, teach, and work in a team (Lakshminarayana et al, 2015;Vietz et al, 2019). Integration of IPE activities into clinical training, such as ward rounds, requires clearly articulated teaching points and feedback on interactions in the team (Walton et al, 2016).…”

Simulated ward round training in the medical curriculum Munich

“…Even though the overall learning objectives and general course structure have not changed over the years, the SiLVi course has been adapted based on the research findings of the working group [ 14 ], [ 15 ], [ 20 ] to meet modern curriculum design in the sense of evidence-based medical education. Among other things, the EPA checklist was included in the course.…”

“…1) ). A second interview study investigated two further ward round settings that were as different as possible - namely surgery and psychiatry - and was able to show that the defined ward round competencies differed only in subject-dependent weighting, but not fundamentally [ 15 ]. The competencies appear to be largely independent of medical disciplines.…”

“…The course duration is 120 min. In the course, the EPA checklist is used, which was developed on the basis of the interview studies [ 15 ], [ 19 ] in a structured method by a team of experts and validated on the basis of 14 filmed real ward rounds [ 20 ]. The checklist is freely available as a supplement to the aforementioned work.…”

“…The duration is approximately 5-10 minutes per ward round scenario. According to our research, this is a realistic time frame (4-12 minutes/patient case) [ 15 ], whereas the ward round duration per patient depends on the complexity of the individual patient case (simple - about 8 minutes; complex - about 18 minutes) [ 20 ]. For illustration purposes, a ward round scenario with the corresponding role descriptions is available as an online attachment (see attachment 1 ).…”