What's the Purpose of Rounds? A Qualitative Study Examining the Perceptions of Faculty and Students

Hulland, Oliver; Farnan, Jeanne M.; Rabinowitz, Raphael; Kearns, Lisa; Long, Michele; Monash, Bradley; Bhansali, Priti; Fromme, H. Barrett

doi:10.12788/jhm.2835

Cited by 24 publications

(15 citation statements)

References 27 publications

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“…Rounds are a complex care routine that occurs daily for most inpatients, although formats vary widely due to overlapping or competing perspectives on the purpose of rounds (Bharwani et al, 2012;Holodinsky et al, 2015;Monash, 2017;Walton et al, 2016). Historically, rounds were uni-professional (typically medicine) and provider-centric.…”

Section: Discussionmentioning

confidence: 99%

A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

Blakeney

Chu

White

et al. 2021

Journal of Interprofessional Care

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Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research. We followed an adapted Arksey and O'Malley Framework and PRISMA scoping review guidelines. PubMed, CINAHL, PsycINFO, and Embase were systematically searched for key IBR words and concepts through June 2020. Seventy-nine articles met inclusion criteria and underwent data abstraction. Study quality was assessed using the Mixed Methods Assessment Tool. Publications in this field have increased since 2014, and the majority of studies reported positive impacts of IBR implementation across an array of team, patient, and care quality/delivery outcomes. Despite the preponderance of positive findings, great heterogeneity, and a reliance on quantitative non-randomized study designs remain in the extant research. A growing number of interventions to improve safety, quality, and care experiences in hospital settings focus on redesigning daily inpatient rounds. Limited information on IBR characteristics and implementation strategies coupled with widespread variation in terminology, study quality, and design create challenges in assessing the effectiveness of models of rounds and optimal implementation strategies. This scoping review highlights the need for additional studies of rounding models, implementation strategies, and outcomes that facilitate comparative research.

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Section: Discussionmentioning

confidence: 99%

A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

Blakeney

Chu

White

et al. 2021

Journal of Interprofessional Care

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“…16 Rabinowitz recommended improving attending teaching strategies and understanding the purpose of rounds. 20,21 Rabinowitz specifically noted the paucity of data guiding faculty development with regards to conducting bedside rounds to "maximize clinical education while minimizing inefficiencies" in today's hurried and fragmented inpatient climate. 20 To our knowledge, our study is the first to use a randomized controlled study design and rigorous evaluation methods to assess the impact of a faculty development intervention to learn to ask an increased number and variety of questions during bedside rounds of more team members.…”

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confidence: 99%

<p>Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings’ Asking Questions</p>

Shields

Honan²,

Goldsmith

et al. 2020

AMEP

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Background: Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement. Objective: To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact. Design: We conducted a randomized, controlled trial to evaluate the efficacy of our intervention. Participants: Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group. Intervention: A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases. Main Measures: Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses. Key Results: Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p<0.003). Residents rated morning bedside rounds with the experimental attendings as significantly more worthwhile compared to rounds with the control group attendings (p=0.009). Conclusion: Our study findings highlight the benefits of a one-hour intervention to teach faculty a method of asking questions during bedside rounds. This educational strategy had the positive outcome of including significantly more resident voices at the bedside. Residents who rounded with attendings in the experimental group were more likely to "strongly agree" that bedside rounds were "worthwhile".

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“…How is it humanly possible to see all the patients on the infamous list, embed teaching, give feedback, engage all the various multi-levels of learners, deliver top-notch care, participate in inter-professional discussions, and concurrently maintain a high level of enthusiasm-all within a 2-hour timeframe? It is no wonder that there is a disconnect [1,2] between what we all know to be the purpose of teaching rounds, and what actually happens during rounds.…”

mentioning

confidence: 99%

The Delicate Dance of Teaching Rounds

Salib

2019

Med.Sci.Educ.

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What's the Purpose of Rounds? A Qualitative Study Examining the Perceptions of Faculty and Students

Cited by 24 publications

References 27 publications

A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

<p>Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings’ Asking Questions</p>

The Delicate Dance of Teaching Rounds

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