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Choi JJ, Osterberg LG, Record JD. Exploring Ward Team Handoffs of Overnight Admissions: Key Lessons from Field Observations. J Gen Intern Med 2024; 39:808-814. [PMID: 38038890 PMCID: PMC11043283 DOI: 10.1007/s11606-023-08549-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND The diagnostic process is a dynamic, team-based activity that is an important aspect of ward rounds in teaching hospitals. However, few studies have examined how academic ward teams operate in areas such as diagnosis in the handoff of overnight admissions during ward rounds. This study draws key lessons from team interactions in the handoff process during ward rounds. OBJECTIVE To describe how ward teams operate in the handoff of patients admitted overnight during ward rounds, and to characterize the role of the bedside patient evaluation in this context. DESIGN A qualitative ethnographic approach using field observations and documentary analysis. PARTICIPANTS Attending physicians, medical residents, and medical students on general medicine services in a single teaching hospital. APPROACH Thirty-five hours of observations were undertaken over a 4-month period. We purposively approached a diverse group of attendings who cover a range of clinical teaching experience, and obtained informed consent from all ward team members and observed patients. Thirty patient handoffs were observed across 5 ward teams with 45 team members. We conducted thematic analysis of researcher field notes and electronic health record documents using social cognitive theories to characterize the dynamic interactions occurring in the real clinical environment. KEY RESULTS Teams spent less time during ward rounds on verifying history and physical examination findings, performing bedside evaluations, and discussing differential diagnoses than other aspects (e.g., reviewing patient data in conference rooms) in the team handoff process of overnight admissions. Several team-based approaches to diagnosis and bedside patient evaluations were observed, including debriefing for learning and decision-making. CONCLUSIONS This study highlights potential strengths and missed opportunities for teaching, learning, and engaging directly with patients in the ward team handoff of patients admitted overnight. These findings may inform curriculum development, faculty training, and patient safety research.
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Affiliation(s)
- Justin J Choi
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
| | - Lars G Osterberg
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Janet D Record
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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2
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Centor RM, Goldszmidt M, Heudebert GR, Heudebert AI, Willett LL, Ratelle JT. Point/Counterpoint: Should patients be presented before entering the room during ward rounds? J Hosp Med 2023; 18:188-192. [PMID: 36380660 DOI: 10.1002/jhm.13003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Robert M Centor
- Internal Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Mark Goldszmidt
- Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Gustavo R Heudebert
- Internal Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Alonso I Heudebert
- Internal Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | | | - John T Ratelle
- Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Escobedo LE, Cervantes L, Havranek E. Barriers in Healthcare for Latinx Patients with Limited English Proficiency-a Narrative Review. J Gen Intern Med 2023; 38:1264-1271. [PMID: 36720766 PMCID: PMC9888733 DOI: 10.1007/s11606-022-07995-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 12/23/2022] [Indexed: 02/02/2023]
Abstract
Latinx (includes Hispanics and is the non-gendered term for Latino/Latina which is a person of Latin American origin or descent) constitutes the largest racial and ethnic minority group in the United States (US). Many members of this group report limited English proficiency, experience discrimination, feel distrust in the healthcare setting, and face poorer health outcomes than non-Latinx Whites. As healthcare systems assess internal structures of care, understanding the experiences of Latinx patients may inform strategies to improve care. This narrative review describes studies that assessed the experiences of Latinx patients with limited English proficiency (LEP) in the inpatient and outpatient settings in the US. We searched PubMed for studies published between January 1, 1990, and March 2021. We reviewed all citations and available abstracts (n = 429). We classified study titles (n = 156) as warranting detailed consideration of the original article. Limited English proficiency is a well-documented challenge reported by Latinx patients seeking care in the outpatient setting, resulting in mistrust of healthcare organizations and clinicians. The effects of LEP overlap substantially with challenges related to patients' immigration status, cultural traditions, and socioeconomic needs. Use of professional interpretation rather than ad hoc interpretation improves trust and satisfaction. There is no consensus about the most effective mode of delivering professional interpretation (in person, telephonic, video conferencing), although rapid simultaneous telephone translation is a promising modality. Increasing awareness of the barriers to effective communication, improving skills in communicating through translators, and increasing the amount of time spent with patients may improve communication and trust more than structural changes like mode of translation or bedside rounding. Cultural fluency training, standardized language training for providers, and incentive pay for fluency are also deserving of further consideration.
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Affiliation(s)
- Luis E Escobedo
- University of Colorado Internal Medicine Residency Training Program, Aurora, CO, USA.
| | - Lilia Cervantes
- Division of Hospital Medicine and General Internal Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
| | - Edward Havranek
- Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA
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van Enk A, Nimmon L, Buckley H, Cuncic C, Canfield C, Veerapen K, Holmes C. Presenting cases in front of patients: implications for a key medical education genre. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:621-643. [PMID: 35366717 DOI: 10.1007/s10459-022-10105-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
Case presentations have been researched as both an important form of intra/inter-professional communication, where a patient's clinical information is shared among health professionals involved in their care, and an equally key discursive tool in education, where learners independently assess a patient and present the case to their preceptor and/or care team. But what happens to the case presentation, a genre that governs physician (and learner) talk about patients, when it is used in patients' presence? While they were commonly used at the bedside in the past, case presentations today are more commonly performed in hallways or conference rooms, out of patient earshot. This paper draws on interview data from a study involving patient-present case presentations in a medical education setting. Our analysis asks what participants' metageneric comments about the encounter can teach us about the genre, about patient involvement in medical education, and about linguistic adaptations to the genre that the profession might make to support patient involvement.
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Affiliation(s)
- Anneke van Enk
- Department of Innovation in Medical Education (DIME), Faculty of Medicine, University of Ottawa, 850 ch. Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
| | - Laura Nimmon
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Heather Buckley
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cary Cuncic
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Carolyn Canfield
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kiran Veerapen
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cheryl Holmes
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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5
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Ratelle JT, Gallagher CN, Sawatsky AP, Kashiwagi DT, Schouten WM, Gonzalo JD, Beckman TJ, West CP. The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:923-930. [PMID: 35020612 PMCID: PMC9126262 DOI: 10.1097/acm.0000000000004586] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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.
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Affiliation(s)
- John T. Ratelle
- J.T. Ratelle is assistant professor of medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0001-8061-283X
| | - Caitlyn N. Gallagher
- C.N. Gallagher is a second-year resident, Department of Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-4906-4019
| | - Adam P. Sawatsky
- A.P. Sawatsky is associate professor of medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-4050-7984
| | - Deanne T. Kashiwagi
- D.T. Kashiwagi is associate professor of medicine, Division of Hospital Internal Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Will M. Schouten
- W.M. Schouten is assistant professor of medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-0448-3615
| | - Jed D. Gonzalo
- J.D. Gonzalo is professor of medicine, Division of General Internal Medicine, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0001-8061-283X
| | - Thomas J. Beckman
- T.J. Beckman is professor of medicine and medical education, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-4343-3936
| | - Colin P. West
- C.P. West is professor of medicine, medical education, and biostatistics, Divisions of General Internal Medicine, and Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-1628-5023
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6
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Grondin C, Houchens N, Gupta A. Quality and Safety in the Literature: November 2021. BMJ Qual Saf 2021; 30:921-926. [PMID: 34497135 DOI: 10.1136/bmjqs-2021-014193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Christopher Grondin
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA .,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Nathan Houchens
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashwin Gupta
- Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Becker C, Gamp M, Schuetz P, Beck K, Vincent A, Hochstrasser S, Metzger K, Widmer M, Thommen E, Mueller B, Fux CA, Leuppi JD, Schaefert R, Langewitz W, Trendelenburg M, Breidthardt T, Eckstein J, Osthoff M, Bassetti S, Hunziker S. Effect of Bedside Compared With Outside the Room Patient Case Presentation on Patients' Knowledge About Their Medical Care : A Randomized, Controlled, Multicenter Trial. Ann Intern Med 2021; 174:1282-1292. [PMID: 34181449 DOI: 10.7326/m21-0909] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Although bedside case presentation contributes to patient-centered care through active patient participation in medical discussions, the complexity of medical information and jargon-induced confusion may cause misunderstandings and patient discomfort. OBJECTIVE To compare bedside versus outside the room patient case presentation regarding patients' knowledge about their medical care. DESIGN Randomized, controlled, parallel-group trial. (ClinicalTrials.gov: NCT03210987). SETTING 3 Swiss teaching hospitals. PATIENTS Adult medical patients who were hospitalized. INTERVENTION Patients were randomly assigned to bedside or outside the room case presentation. MEASUREMENTS The primary endpoint was patients' average knowledge of 3 dimensions of their medical care (each rated on a visual analogue scale from 0 to 100): understanding their disease, the therapeutic approach being used, and further plans for care. RESULTS Compared with patients in the outside the room group (n = 443), those in the bedside presentation group (n = 476) reported similar knowledge about their medical care (mean, 79.5 points [SD, 21.6] vs. 79.4 points [SD, 19.8]; adjusted difference, 0.09 points [95% CI, -2.58 to 2.76 points]; P = 0.95). Also, an objective rating of patient knowledge by the study team was similar for the 2 groups, but the bedside presentation group had higher ratings of confusion about medical jargon and uncertainty caused by team discussions. Bedside ward rounds were more efficient (mean, 11.89 minutes per patient [SD, 4.92] vs. 14.14 minutes per patient [SD, 5.65]; adjusted difference, -2.31 minutes [CI, -2.98 to -1.63 minutes]; P < 0.001). LIMITATION Only Swiss hospitals and medical patients were included. CONCLUSION Compared with outside the room case presentation, bedside case presentation was shorter and resulted in similar patient knowledge, but sensitive topics were more often avoided and patient confusion was higher. Physicians presenting at the bedside need to be skilled in the use of medical language to avoid confusion and misunderstandings. PRIMARY FUNDING SOURCE Swiss National Foundation (10531C_ 182422).
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Affiliation(s)
- Christoph Becker
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Martina Gamp
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Philipp Schuetz
- University of Basel, Basel, and Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M., C.A.F.)
| | - Katharina Beck
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Alessia Vincent
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Seraina Hochstrasser
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Kerstin Metzger
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Madlaina Widmer
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Emanuel Thommen
- University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.)
| | - Beat Mueller
- University of Basel, Basel, and Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M., C.A.F.)
| | - Christoph A Fux
- University of Basel, Basel, and Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M., C.A.F.)
| | - Jörg D Leuppi
- University of Basel, Basel, and University Clinic of Medicine, Kantonsspital Baselland, Liestal, Switzerland (J.D.L.)
| | - Rainer Schaefert
- University Hospital Basel and University of Basel, Basel, Switzerland (R.S., W.L., S.H.)
| | - Wolf Langewitz
- University Hospital Basel and University of Basel, Basel, Switzerland (R.S., W.L., S.H.)
| | - Marten Trendelenburg
- University of Basel and University Hospital Basel, Basel, Switzerland (M.T., T.B., J.E., M.O., S.B.)
| | - Tobias Breidthardt
- University of Basel and University Hospital Basel, Basel, Switzerland (M.T., T.B., J.E., M.O., S.B.)
| | - Jens Eckstein
- University of Basel and University Hospital Basel, Basel, Switzerland (M.T., T.B., J.E., M.O., S.B.)
| | - Michael Osthoff
- University of Basel and University Hospital Basel, Basel, Switzerland (M.T., T.B., J.E., M.O., S.B.)
| | - Stefano Bassetti
- University of Basel and University Hospital Basel, Basel, Switzerland (M.T., T.B., J.E., M.O., S.B.)
| | - Sabina Hunziker
- University Hospital Basel and University of Basel, Basel, Switzerland (R.S., W.L., S.H.)
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Thomas C, Plumblee L, Dieffenbaugher S, Talley C. Teaching on Rounds and in Small Groups. Surg Clin North Am 2021; 101:555-563. [PMID: 34242599 DOI: 10.1016/j.suc.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bedside teaching plays a vital role the training future physicians, allowing for instruction in history taking, physical examination skills, differential diagnosis development, professionalism, teamwork integration, effective communication, and discussions of medical ethics. Due to changes in the health care system, accreditation bodies, and shortened admittance of patients, rates of bedside teaching have declined. Attending surgeons feel increased external pressures to meet performance metrics while resident physicians adhere to duty hour restrictions. This article highlights popular methods, including bedside rounds, near-peer teaching, and resident versus attending preceptors, and discusses how teaching on rounds has an impact on patients.
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Affiliation(s)
- Christopher Thomas
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Leah Plumblee
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Sean Dieffenbaugher
- Carolinas Medical Center, Atrium Health, Department of Surgery, 1000 Blythe Boulevard, MEB Office 601, Charlotte, NC 28203, USA
| | - Cynthia Talley
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
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Ratelle JT, Herberts M, Miller D, Kumbamu A, Lawson D, Polley E, Beckman TJ. Relationships Between Time-at-Bedside During Hospital Ward Rounds, Clinician-Patient Agreement, and Patient Experience. J Patient Exp 2021; 8:23743735211008303. [PMID: 34179432 PMCID: PMC8205390 DOI: 10.1177/23743735211008303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hospital medicine ward rounds are often conducted away from patients' bedsides, but it is unknown if more time-at-bedside is associated with improved patient outcomes. Our objective is to measure the association between "time-at-bedside," patient experience, and patient-clinician care agreement during ward rounds. Research assistants directly observed medicine services to quantify the amount of time spent discussing each patient's care inside versus outside the patient's room. "Time-at-bedside" was defined as the proportion of time spent discussing a patient's care in his or her room. Patient experience and patient-clinician care agreement both were measured immediately after ward rounds. Results demonstrated that the majority of patient and physicians completely agreement on planned tests (66.3%), planned procedures (79.7%), medication changes (50.6%), and discharge location (66.9%), but had no agreement on the patient's main concern (74.4%) and discharge date (50.6%). Time-at-bedside was not correlated with care agreement or patient experience (P > .05 for all comparisons). This study demonstrates that spending more time at the bedside during ward rounds, alone, is insufficient to improve patient experience.
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Affiliation(s)
- John T Ratelle
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michelle Herberts
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Donna Miller
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ashok Kumbamu
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of
Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Donna Lawson
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Eric Polley
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Thomas J Beckman
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Impact of Fellows-as-Teachers Workshops on Teaching Rounds: An Observational Study in an ICU. Crit Care Explor 2020; 2:e0235. [PMID: 33134936 PMCID: PMC7581023 DOI: 10.1097/cce.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is available in the text. During training, fellows serve as teachers and role models for junior colleagues. Fellows-as-teachers curricula may support these roles, but little is known about their effectiveness and durability. We sought to measure the long-term effects on ICU rounds after administering fellows-as-teachers workshops.
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11
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Bryne A, Wiese J. Using Bedside Rounds to Change Culture. Med Clin North Am 2020; 104:739-750. [PMID: 32505264 DOI: 10.1016/j.mcna.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although not suitable for every patient encounter, rounding at the beside provides an opportunity to teach and augment the attitudes essential for optimal medical care. It also provides an opportunity to establish and grow the team's culture as well as the culture for each patient encounter. Finally, it provides the attending physician with an opportunity to assess learners' position on the supervision-to-autonomy spectrum, thereby ensuring appropriate supervision while enabling the autonomy necessary for optimal learner growth.
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Affiliation(s)
- Abigail Bryne
- Department of Internal Medicine, Tulane University, 1430 Tulane Avenue SL-15, New Orleans, LA 70115, USA
| | - Jeff Wiese
- Department of Internal Medicine, Tulane University, 1430 Tulane Avenue SL-15, New Orleans, LA 70115, USA.
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