HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.
South Med J. 2023 Aug;116(8):690-695. doi: 10.14423/SMJ.0000000000001588.
Inpatient rounding is a foundational component of medical education in academic hospitals. The coronavirus 2019 (COVID-19) pandemic disrupted traditional inpatient rounding practices. The objectives of this study were to describe how Internal Medicine inpatient team rounding changed because of COVID-19-related precautions and the effect of these changes on education during rounds.
During February to March 2021, we conducted four virtual focus groups with medical and physician assistant students, interns, upper-level residents, and attending physicians at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, and designed a codebook to categorize focus group commentary.
Focus groups revealed that students believed that certain physical-distancing measures in place early on during the pandemic were ineffective and significantly limited their ability to evaluate patients in person. Residents described increased stress levels related to potential severe acute respiratory-coronavirus 2 exposure and limited time at the bedside, which affected their confidence with clinical assessments. Rounding-team fragmentation precluded the entire team learning from all of the patients on the team's census. Loss of intrateam camaraderie impaired the development of comfortable learning environments.
This study evaluated Internal Medicine team member focus groups to describe how the COVID-19 pandemic affected medical education during rounds. Academic teaching programs can adapt the findings from this study to address and prevent pandemic-related gaps in medical education during rounds now and during future potential disruptions to medical education.
住院查房是学术医院医学教育的基础组成部分。2019 年冠状病毒病（COVID-19）大流行打乱了传统的住院查房实践。本研究的目的是描述由于 COVID-19 相关预防措施，内科住院团队查房发生了怎样的变化，以及这些变化对查房期间教育的影响。
2021 年 2 月至 3 月，我们在德克萨斯州休斯顿迈克尔 E.德贝基退伍军人事务医疗中心对医学和医师助理学生、实习医生、高级住院医生和主治医生进行了四次虚拟焦点小组讨论，并设计了一个代码本对焦点小组评论进行分类。
焦点小组显示，学生们认为大流行早期实施的某些身体距离措施效果不佳，严重限制了他们亲自评估患者的能力。住院医生描述了与潜在严重急性呼吸冠状病毒 2 暴露相关的压力水平增加以及在床边的时间有限，这影响了他们对临床评估的信心。查房团队的碎片化使得整个团队无法从团队成员的所有患者中学习。团队内部友谊的丧失阻碍了舒适学习环境的发展。
本研究通过内科团队成员焦点小组评估了 COVID-19 大流行如何影响查房期间的医学教育。学术教学计划可以根据本研究的结果，在现在和未来医学教育可能受到干扰期间，解决和预防查房期间医学教育方面的相关差距。
