Promoting Autonomy in Pediatric Trainees: Independent Rounding on a Pediatric Hospital Medicine Service.

Area of Science:

• Medical Education
• Graduate Medical Education
• Pediatric Residency Training

Background:

• Trainee autonomy is a key value in graduate medical education.
• Previous studies indicate a gap between resident-perceived autonomy and attending-reported autonomy.
• Independent rounding (IR) is a practice shown to enhance trainee autonomy.

Purpose of the Study:

• To promote graduated trainee autonomy through the implementation of independent rounding.
• To explore interprofessional perspectives on the implementation of independent rounding.
• To assess the impact of independent rounding on patient safety, teaching, and workflow.

Main Methods:

• A single-center, mixed-methods study conducted at a quaternary children's hospital from July 2021 to June 2022.
• Independent rounding was implemented on one inpatient pediatric team one day per week.
• Post-study surveys were administered to resident trainees, medical students, attending physicians, and nurses.

Main Results:

• The study included 26 medical students, 41 interns, 22 senior residents, and 15 attending physicians.
• Independent rounding was well-received by all participant groups.
• Senior residents reported improved autonomy; overall perceptions of patient safety, teaching, and workflow showed improvement or no change.

Conclusions:

• Independent rounding is a feasible method for enhancing graduated trainee autonomy.
• The practice was positively received by both trainees and attending physicians.
• Trainees expressed a desire for more frequent independent rounding opportunities.