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Published on: January 16, 2019
An observational study of attending rounds.
M Miller1, B Johnson, H L Greene
1University of Arizona, Tucson.
Journal of General Internal Medicine
|November 1, 1992
Summary
Attending physicians spent most clinical teaching time in conference rooms, not at the bedside. This observational study highlights opportunities to improve medical education during attending rounds.
Area of Science:
- Medical Education
- Internal Medicine Training
- Clinical Teaching Methods
Background:
- Attending rounds are a cornerstone of clinical teaching in internal medicine.
- The optimal allocation of time during attending rounds is not well-defined.
- Understanding current practices is essential for improving educational effectiveness.
Purpose of the Study:
- To assess the current time allocation of attending physicians during clinical teaching rounds.
- To compare estimated versus actual time spent on various activities during rounds.
- To identify areas for improvement in the structure and delivery of attending rounds.
Main Methods:
- An observational study was conducted in a university-based internal medicine department.
- Data were collected using questionnaires and timed direct observations.
- Physician activities were categorized and time spent in different locations was recorded.
Main Results:
- Attending physicians spent 63% of their time in conference rooms, 26% in hallways, and only 11% at the patient bedside.
- Significant discrepancies existed between estimated and observed time for patient discussions, interactions, data reviews, and presentations.
- The study identified a substantial amount of time allocated to 'other' activities.
Conclusions:
- Current attending rounds predominantly occur outside the patient room, limiting direct patient interaction and bedside teaching.
- Discrepancies in time allocation suggest a need for structured interventions to optimize clinical teaching.
- A teaching workshop intervention could potentially improve the effectiveness of attending rounds.
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