Orthopedic grand rounds can change resident practice

Area of Science:

• Medical Education
• Geriatric Medicine
• Orthopedic Surgery

Background:

• Documentation of advanced directives and code status is crucial for elderly hip fracture patients.
• Previous practice among orthopedic residents lacked consistent documentation in this area.

Purpose of the Study:

• To evaluate the impact of a grand rounds presentation on resident documentation of patient care preferences.
• To assess changes in orthopedic resident practice regarding advanced directives and code status for hip fracture patients.

Main Methods:

• A retrospective review of medical records for hip fracture patients aged 65 and older was conducted.
• Documentation rates of advanced directives and code status were assessed before and after an educational grand rounds presentation.
• Resident attendance at the grand rounds was correlated with documentation practices.

Main Results:

• Prior to the presentation, residents documented advanced directives and code status in 0% of cases.
• Following the grand rounds, documentation increased to 76% for all residents.
• Residents who attended the presentation documented significantly more often (88%) than those who did not (20%).

Conclusions:

• Grand rounds presentations can effectively change resident practice regarding critical patient care documentation.
• Targeted medical education is a viable strategy to improve adherence to best practices in orthopedic surgery.
• Resident engagement with educational interventions directly correlates with improved clinical documentation outcomes.