Ward rounds: can an aide‐memoire help new doctors?

Abstract

In the initial survey (2015), 42% (n = 19) of the 45 FY1s in NLaG responded: 84% (n = 16) reported conducting ward rounds alone twice or more each week, with 5% (n = 1) feeling prepared and 89% (n = 17) feeling unprepared to do so. In the second survey (2016), following the introduction of the aide-memoire, 52% (n = 25) of the 48 FY1s responded: 32% (n = 7) reported feeling prepared with the aide-memoire (a 27% increase from 2015). There was also a statistically significant increase in the frequency with which they reported considering three of 13 important aspects of care: nutrition, mobility and discharge planning. There are no studies exploring the frequency with which newly graduated doctors conduct ward rounds alone DISCUSSION: The FY1s were regularly conducting ward rounds alone, and felt unprepared for this. An aide-memoire is a low-cost intervention with some value in improving preparedness, and could be further developed and used elsewhere.

Workforce: Newly graduated doctors’ experiences of conducting medical ward rounds alone: A regional cross-sectional study

“…These findings reinforce previous data demonstrating that FY1s are regularly conducting ward rounds alone, 6 but the proportion of FY1s reporting conducting ward rounds alone twice or more each week in this study was slightly lower than in the previous study 6 (62% vs 84% respectively). One potential explanation could be that the previous study was conducted in two small district general hospitals (DGHs) 6 whereas this study was conducted across YHFS, encompassing both DGHs and tertiary centres. It also supports previous studies demonstrating low levels of confidence and self-reported preparedness for ward round conduct.…”

“…It also supports previous studies demonstrating low levels of confidence and self-reported preparedness for ward round conduct. [5][6][7] Less than half of those surveyed had received prior training in ward round conduct, which is in keeping with the previously described findings of Powell et al . 5 This study in YHFS is the largest of its kind, covers a wide geographical area and encompasses both DGHs and tertiary centres giving stronger external validity.…”

“…2 Previous quality improvement work undertaken by Pearce, Redman and Gajebasia et al revealed that 85% (n=16) of 19 foundation year 1 doctors (FY1s) in one NHS trust (consisting of two district general hospitals which host FY1s) reported conducting medical ward rounds alone twice or more each week. 6 Furthermore, 89% (n=17) of respondents reported feeling unprepared for conducting ward rounds alone, 6 a finding supported by two other studies that demonstrated low levels of confidence for ward round conduct and related skills in medical students and foundation doctors. 5 , 7 The high frequency of FY1-led ward rounds 6 and lack of self-perceived preparedness [5][6][7] is concerning, especially given the lack of prior training 5 and skill deficit 2 identified in this area.…”

“…6 Furthermore, 89% (n=17) of respondents reported feeling unprepared for conducting ward rounds alone, 6 a finding supported by two other studies that demonstrated low levels of confidence for ward round conduct and related skills in medical students and foundation doctors. 5 , 7 The high frequency of FY1-led ward rounds 6 and lack of self-perceived preparedness [5][6][7] is concerning, especially given the lack of prior training 5 and skill deficit 2 identified in this area. The studies exploring this area to date are limited in number, and are predominantly small, local studies, but they clearly highlight the need for larger scale exploration into newly graduated doctors' experiences of conducting ward rounds alone.…”

“…5 , 10-13 A simple aide-memoire outlining aspects of care to consider on ward rounds has also been demonstrated to be of value to provide a framework for experiential learning on the wards. 6 As might be expected, there were a number of decisions that the majority of FY1s could not make without delay, such as requesting complex investigations and those surrounding discharge and end-of-life care, indicating the possible implications of regular FY1-led ward rounds on patient care. These findings highlight the importance of having systems in place to ensure that timely senior support is available to FY1s at all times, both to improve patient care and to improve the experience and educational value for FY1s.…”