Munson Family Medicine Residency, Traverse City, Michigan, USA.
Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Clin Teach. 2021 Feb;18(1):51-54. doi: 10.1111/tct.13232. Epub 2020 Aug 27.
It is challenging to achieve quality teaching on a busy resident service. Teams must balance the competing drivers of patient care, clinical efficiency, patient satisfaction and resident learning. Our novel outdoor walking rounds improve both the quality of resident instruction and their physician wellness without negatively affecting patient care.
Our team meets outside for attending rounds on the sidewalks or hiking trails near our hospital. The residents present their clinical plans as we walk. We are able to achieve more in-depth clinical discussions and teaching than with traditional rounds conducted inside. Residents were surveyed to compare their experiences with traditional rounds.
Twenty-seven residents were surveyed over 5 years (29.6% were first-year residents, 33.3% were second-year residents and 37.0% were third-year residents): 81% of residents indicated that walking rounds improved the time dedicated to teaching; 100% of residents believed that the quality of teaching had improved; 70% of residents indicated that walking rounds improved their sense of physician wellness; and 59% of residents identified that walking rounds were as efficient, or more efficient, than traditional rounds.
Striving to provide in-depth resident clinical teaching without negatively affecting the quality and efficiency of patient care is a tall order. Outdoor walking rounds are a teaching method that combines dedicated non-distracted time for resident teaching with exercise. Our study indicates that this teaching method improves the quantity and quality of dedicated teaching time, improves resident physician wellness and does so in an innovative way that maintains efficient patient care.
在繁忙的住院医师服务中实现高质量教学具有挑战性。团队必须平衡患者护理、临床效率、患者满意度和住院医师学习的竞争驱动因素。我们新颖的户外巡回改善了住院医师教学的质量和他们医生的健康，而不会对患者护理产生负面影响。
我们的团队在户外进行巡回，在医院附近的人行道或徒步小径上进行。住院医师在我们散步时介绍他们的临床计划。与在室内进行的传统巡回相比，我们能够进行更深入的临床讨论和教学。对住院医师进行了调查，以比较他们的传统巡回经验。
在 5 年的时间里对 27 名住院医师进行了调查（29.6%的住院医师为第一年，33.3%的住院医师为第二年，37.0%的住院医师为第三年）：81%的住院医师表示，户外巡回改善了用于教学的时间；100%的住院医师认为教学质量有所提高；70%的住院医师表示户外巡回改善了他们的医生健康意识；59%的住院医师认为户外巡回与传统巡回一样高效，或更高效。
努力提供深入的住院医师临床教学，同时又不影响患者护理的质量和效率，这是一项艰巨的任务。户外步行巡回是一种教学方法，它将专门用于住院医师教学的非分散时间与锻炼结合起来。我们的研究表明，这种教学方法提高了专门教学时间的数量和质量，改善了住院医师医生的健康状况，而且是以一种保持高效患者护理的创新方式。
