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A case study of medical grand rounds: are we using effective methods?
Thomas J Van Hoof1, Robert J Monson, Gibran T Majdalany
1University of Connecticut School of Nursing, Storrs, Connecticut 06269-2026, USA. tom.vanhoof@uconn.edu
Summary
Grand rounds, a key continuing medical education activity, often fall short of evidence-based educational practices. This study highlights opportunities to improve physician training and patient outcomes through better grand rounds program design.
Area of Science:
- Medical Education
- Continuing Professional Development
Background:
- Grand rounds are a traditional method for continuing medical education (CME) for physicians.
- They are intended to maintain physician competence and drive practice change for improved patient outcomes.
- The alignment of current grand rounds with evidence-based educational practices is not well understood.
Purpose of the Study:
- To evaluate a specific medical grand rounds program at a U.S. academic medical center.
- To determine the extent to which this program aligns with five established evidence-based educational practices.
- To identify areas for improvement in grand rounds program design and delivery.
Main Methods:
- An instrumental case study approach was employed in 2007.
- Qualitative data were gathered through observations, interviews, and focus groups with planners, presenters, and participants.
- An inductive analysis was used to assess adherence to five key educational practices.
Main Results:
- The evaluated grand rounds program minimally incorporated the five evidence-based practices: needs assessment, multifaceted intervention, sequencing, interaction, and commitment to change.
- Sessions were characterized by passive, slide-driven presentations on diverse subspecialty topics.
- Limited opportunities for audience interaction and inconsistent attendance, especially among non-faculty, were noted.
Conclusions:
- Significant opportunities exist to enhance the effectiveness of this specific grand rounds program.
- Further research into similar traditional educational forums for physicians is warranted.
- Improving grand rounds can potentially enhance physician behavior and patient care.
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