Internal medicine program directors' perceptions of resident work rounds

Area of Science:

• Medical Education
• Internal Medicine Residency Training
• Healthcare Administration

Background:

• Work rounds are crucial for resident education but receive limited attention in literature.
• Second-year postgraduate residents are expected to lead teams and teach with minimal guidance.
• New York State health regulations may impact work round structure and content.

Purpose of the Study:

• Identify and evaluate the perceived goals of work rounds in Internal Medicine residency programs.
• Assess resident behaviors (patient care, teaching, evaluation) during work rounds.
• Determine the alignment between perceived goals and actual practices in New York State programs.

Main Methods:

• Cross-sectional descriptive study utilizing a 36-item questionnaire.
• Survey administered to Program Directors of New York State Internal Medicine residency programs.
• Goals categorized based on resident behaviors: patient care, teaching, and evaluation.

Main Results:

• Patient management and updating the team leader were highest-rated goals.
• High importance placed on patient management, teaching clinical reasoning, verifying data, and physical exams.
• Most programs use verbal instructions; few offer conferences or literature on work round conduct.

Conclusions:

• New York State Internal Medicine program directors view work rounds primarily as a patient care activity.
• Reliance on verbal instructions may lead to missed educational opportunities during work rounds.
• Work rounds represent a significant, yet potentially underutilized, educational setting for residents.