Observing bedside rounds for faculty development.

Area of Science:

• Medical Education
• Clinical Teaching
• Healthcare Quality Improvement

Background:

• Bedside rounds are a crucial setting for clinical teaching.
• Previous faculty development focused on balancing autonomy, patient care, and teaching.
• Discrepancies in perceptions between attending physicians and learners regarding bedside rounds were noted.

Purpose of the Study:

• To investigate shared and differing perceptions of bedside rounds between attending physicians and learners.
• To identify areas of discordance to inform faculty development for optimizing bedside rounds.
• To understand the impact of learner autonomy, patient-centeredness, efficiency, and educational value on bedside teaching.

Main Methods:

• Observation of 16 attending physicians and 47 learners across 112 patient encounters.
• Data collection on round length and interruptions.
• Surveying participants on perceptions of attending physician efficacy, efficiency, and educational value.

Main Results:

• Learners reported significantly higher perceptions of patient-centeredness, efficiency, and educational value compared to attending physicians.
• Learners rated attending physicians higher on learner autonomy, supervision, responsibility delegation, and reduced interruptions.
• No correlation found between interruptions and round length or participant perceptions.

Conclusions:

• Salient beliefs and practices in bedside teaching were identified.
• Aligning goals and expectations, and establishing metrics for successful rounds can enhance synergy.
• Interruptions do not necessarily detract from efficient rounds; faculty development should integrate these findings.