University of Alabama at Birmingham Department of Internal Medicine, Birmingham, AL, USA.
J Gen Intern Med. 2012 Nov;27(11):1492-8. doi: 10.1007/s11606-012-2121-6. Epub 2012 Jun 22.
Ward attending rounds are an integral part of internal medicine education. Being a good teacher is necessary, but not sufficient for successful rounds. Understanding perceptions of successful attending rounds (AR) may help define key areas of focus for enhancing learning, teaching and patient care.
We sought to expand the conceptual framework of 30 previously identified attributes contributing to successful AR by: 1) identifying the most important attributes, 2) grouping similar attributes, and 3) creating a cognitive map to define dimensions and domains contributing to successful rounds.
Multi-institutional, cross-sectional study design.
We recruited residents and medical students from a university-based internal medicine residency program and a community-based family medicine residency program. Faculty attending a regional general medicine conference, affiliated with multiple institutions, also participated.
Participants performed an unforced card-sorting exercise, grouping attributes based on perceived similarity, then rated the importance of attributes on a 5-point Likert scale. We translated our data into a cognitive map through multi-dimensional scaling and hierarchical cluster analysis.
Thirty-six faculty, 49 residents and 40 students participated. The highest rated attributes (mean rating) were "Teach by example (bedside manner)" (4.50), "Sharing of attending's thought processes" (4.46), "Be approachable-not intimidating" (4.45), "Insist on respect for all team members" (4.43), "Conduct rounds in an organized, efficient & timely fashion" (4.39), and "State expectations for residents/students" (4.37). Attributes were plotted on a two-dimensional cognitive map, and adequate convergence was achieved. We identified five distinct domains of related attributes: 1) Learning Atmosphere, 2) Clinical Teaching, 3) Teaching Style, 4) Communicating Expectations, and 5) Team Management.
We identified five domains of related attributes essential to the success of ward attending rounds.
病房查房是内科医学教育的重要组成部分。成为一名好老师是必要的，但对于成功的查房来说还不够。了解成功查房的认知观念可能有助于确定重点关注领域，以提高学习、教学和患者护理的质量。
我们旨在通过以下方式扩展 30 项先前确定的有助于成功查房的属性的概念框架：1）确定最重要的属性；2）将相似的属性分组；3）创建认知图以定义有助于成功查房的维度和领域。
多机构、横断面研究设计。
我们从一所大学的内科住院医师培训计划和一所社区为基础的家庭医学住院医师培训计划中招募住院医师和医学生，参加一个区域普通医学会议的多机构附属教员也参与了研究。
参与者进行了非强制性的卡片分类练习，根据感知的相似性对属性进行分组，然后对属性的重要性进行 5 点李克特量表评分。我们通过多维尺度分析和层次聚类分析将我们的数据转化为认知图。
共有 36 名教员、49 名住院医师和 40 名学生参与了研究。评分最高的属性（平均评分）为：“以身作则（床边态度）”（4.50）、“分享主治医生的思维过程”（4.46）、“易于接近而不令人生畏”（4.45）、“坚持尊重所有团队成员”（4.43）、“以组织、高效和及时的方式进行查房”（4.39）以及“向住院医师/学生说明期望”（4.37）。属性被绘制在二维认知图上，并且达到了足够的收敛。我们确定了五个不同的相关属性领域：1）学习氛围，2）临床教学，3）教学风格，4）沟通期望，以及 5）团队管理。
我们确定了五个与病房查房成功相关的属性领域，这些领域对于成功查房至关重要。
