From the Department of Medicine, Division of Infectious Diseases, and the Department of Medicine, Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, and the Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.
South Med J. 2022 May;115(5):294-300. doi: 10.14423/SMJ.0000000000001390.
Bedside rounds provide a valuable opportunity for residents to learn vital clinical skills, yet they are increasingly being replaced by card-flip rounds in conference rooms. Residents express mixed views about the educational value of bedside rounds; however, little is known about their perspectives regarding how the structure and content of bedside rounds can be optimized for their learning. We sought to explore residents' attitudes toward bedside rounds and perceptions regarding how to maximize their educational value.
Hospital Medicine faculty at one hospital were instructed to bedside round with their teams daily. Focus groups with residents after the rotation explored their perspectives on the educational value of bedside rounds. Thematic analysis identified modifiable factors that affected resident learning to inform future faculty development efforts.
Interns described four categories of modifiable factors that impacted their learning during bedside rounds: institutional factors, such as patient geography and computer availability; rounding structure, including length of rounds, patient selection, and location of patient presentations; faculty behaviors, such as preparation for rounds, establishing explicit expectations for rounds, creating a safe learning climate, and promoting intern autonomy; and educational content, including whether it was targeted to the appropriate learner level and consisted of content appropriate for the bedside.
Residents outlined institutional factors that should be addressed and three high-yield content areas for faculty development programs: rounding structures, faculty behaviors, and bedside educational content. These findings helped us develop guidelines and faculty development sessions for attendings engaging in bedside rounds.
床边查房为住院医师提供了一个学习重要临床技能的宝贵机会，但它们越来越多地被会议室中的卡片式查房所取代。住院医师对床边查房的教育价值表达了混合的观点；然而，对于如何优化床边查房的结构和内容以提高其教育价值，人们知之甚少。我们试图探讨住院医师对床边查房的态度以及他们对如何最大限度地提高其教育价值的看法。
一家医院的医院医学教师被指示每天与他们的团队进行床边查房。轮转后的住院医师焦点小组探讨了他们对床边查房教育价值的看法。主题分析确定了影响住院医师学习的可修改因素，以为未来的教师发展努力提供信息。
实习医师描述了影响他们在床边学习的四类可修改因素：机构因素，如患者地理位置和计算机可用性；查房结构，包括查房的长度、患者选择和患者介绍的地点；教师行为，如查房准备、明确查房期望、营造安全的学习氛围和促进实习医师自主性；以及教育内容，包括内容是否针对适当的学习者水平以及是否包含适合床边的内容。
住院医师概述了应解决的机构因素和三个高收益的教师发展计划内容领域：查房结构、教师行为和床边教育内容。这些发现帮助我们为参与床边查房的主治医生制定了指导方针和教师发展课程。
