A Mnemonic for Effective "Lesss PAINFUL" Pre-Rounding

Due to much of medical training being inpatient centered, medical trainees generally do more pre-rounding on a per-patient basis than they do complete histories and physical exams (H&Ps). However, formal training often overlooks pre-rounding as a critical aspect of medical education and patient care, with at least 10 times more publications on H&Ps than on any other aspect of rounding over the past half-century. To address this critical gap in medical education, we introduce the "Lesss PAINFUL" pre-rounding mnemonic, emphasizing the importance of efficient pre-rounding for medical students or other trainees. The mnemonic guides trainees through Progress, Presenting symptoms, Physical, Autonomy, Ambulation, Ins and Outs, Nursing, Needs before discharge, and Follow-Up Labs and imaging, providing a systematic framework to ease the burden of learning pre-rounding. The extra "s" in "Lesss" is to emphasize that each letter in the PAINFUL mnemonic represents multiple aspects per acronym letter. This mnemonic has substantial potential to streamline both medical training and inpatient care by serving as an effective internal checklist to ensure a thorough evaluation by the learner, thereby contributing to the overall quality of care for hospitalized patients. As medical education evolves, incorporating mnemonic-based strategies like "Lesss PAINFUL" holds promise for enriching and solidifying the skills of future healthcare practitioners.