Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison 53792, USA.
Acad Pediatr. 2011 Sep-Oct;11(5):403-8. doi: 10.1016/j.acap.2011.01.001. Epub 2011 Mar 10.
Family-centered bedside rounds (FCBRs) are recommended to improve trainee education, patient outcomes, and family satisfaction. However, bedside teaching has waned in recent years, potentially leading to less teaching and more concern for trainees. We examined medical students' concerns, teaching evaluations, and attitudes after experiencing FCBRs during the pediatric clerkship.
Data are both cross-sectional and pre-clerkship and post-clerkship surveys for 113 (89%) of 127 students. Students reported frequencies of post-clerkship concerns (14 items) and teaching experiences (17 items), with 5 response options (1 = never, 2 = rarely, 3 = occasionally, 4 = usually, 5 = always, dichotomized with "frequent" being usually or occasionally). Students reported pre-clerkship and post-clerkship attitudes for 4 items on a 7-point scale (1 = strongly disagree, 7 = strongly agree). Analyses included adjusted means or proportions.
The most commonly endorsed concern was presenting information in a way that was understandable to patients and families, with 34.5% of students having this concern frequently. The majority of students frequently experienced 12 of 17 teaching items. Effective teaching of physical exam skills was the teaching item least often experienced frequently by students (20.3%). Student attitudes about the benefits of FCBRs for families were significantly more positive post-clerkship (mean change, 0.37 points; P < .001), but they remained neutral in their preference for FCBRs over traditional rounds without the family present (mean change, -0.14 points; P > .05).
Although students demonstrate positive attitudes toward FCBRs and report frequent occurrence of inpatient teaching elements, findings suggest opportunities for easing student concerns and for using this venue to teach exam skills.
以家庭为中心的床边查房（FCBRs）被推荐用于改善学员教育、患者结局和家庭满意度。然而，近年来床边教学已经减少，这可能导致教学减少，对学员的关注增加。我们调查了医学生在儿科实习期间体验 FCBRs 后的担忧、教学评估和态度。
数据包括 127 名学生中的 113 名（89%）的横断面和实习前及实习后的调查。学生报告了实习后的担忧频率（14 项）和教学经验（17 项），有 5 种反应选择（1 = 从不，2 = 很少，3 = 偶尔，4 = 通常，5 = 总是，以“通常”或“偶尔”归类为“频繁”）。学生报告了 4 项 7 点量表（1 = 强烈不同意，7 = 强烈同意）的实习前和实习后的态度。分析包括调整后的平均值或比例。
最常被认可的担忧是向患者和家属以可理解的方式呈现信息，有 34.5%的学生经常有这种担忧。大多数学生经常经历 17 项教学内容中的 12 项。学生最不经常经历的教学项目是有效的体检技能教学（20.3%）。学生对 FCBRs 对家庭益处的态度在实习后明显更为积极（平均变化 0.37 分；P <.001），但他们对 FCBRs 与没有家属在场的传统查房之间的偏好仍保持中立（平均变化 -0.14 分；P >.05）。
尽管学生对 FCBRs 表现出积极的态度，并报告了经常发生的住院教学内容，但调查结果表明，有机会减轻学生的担忧，并利用这一场所教授检查技能。
