School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, UK.
Perspect Med Educ. 2023 Dec 19;12(1):550-564. doi: 10.5334/pme.930. eCollection 2023.
Schwartz Rounds ("Rounds") are a confidential group reflection forum, increasingly adopted to support pre-registration healthcare students. This realist review aims to understand what the available literature and key informant interviews can tell us about Rounds in this setting, asking what works, for whom, in what circumstances, and why?
Published literature discussing Rounds in undergraduate settings were analysed using realist methods to describe how, for whom and in which contexts Rounds work. Four key informants were interviewed using realist methods, to further develop, test and refine a programme theory of Rounds in undergraduate settings.
We identified five core features and five contextual adaptations.Core: Rounds provide a reflective space to discuss emotional challenges; Rounds promote an open and humanised professional culture; Rounds offer role-modelling of vulnerability, enabling interpersonal connectedness; Rounds are impactful when focused on emotional and relational elements; Rounds offer reflective insights from a wide range of perspectives.Contextual adaptations: Rounds allow reflection to be more engaging for students when they are non-mandatory; perceptions of safety within a Round varies based on multiple factors; adapting timing and themes to students' changing needs may improve engagement; resonance with stories is affected by clinical experience levels; online adaptation can increase reach but may risk psychological safety.
Schwartz Rounds are a unique intervention that can support healthcare students through their pre-registration education. The five "core" and five "contextual adaptation" features presented identify important considerations for organisations implementing Rounds for their undergraduates.
Schwartz 轮（"Rounds"）是一种保密的小组反思论坛，越来越多地被用于支持预注册医疗保健学生。本真实主义综述旨在了解现有文献和关键知情人访谈可以告诉我们在这种情况下的轮次，了解什么是有效的，针对谁，在什么情况下，以及为什么？
使用真实主义方法分析了讨论本科生轮次的已发表文献，以描述轮次在何种情况下、针对谁以及如何发挥作用。使用真实主义方法对四名关键知情人进行了访谈，以进一步发展、测试和完善本科生轮次的计划理论。
我们确定了五个核心特征和五个情境调整。核心特征：轮次提供了一个讨论情感挑战的反思空间；轮次促进了开放和人性化的专业文化；轮次提供了脆弱性的榜样，促进人际联系；当关注情感和关系要素时，轮次具有影响力；轮次提供了来自广泛视角的反思见解。情境调整：当轮次是非强制性时，更能吸引学生的注意力；在轮次中对安全性的感知取决于多个因素；根据学生不断变化的需求调整时间和主题可能会提高参与度；与故事的共鸣受临床经验水平的影响；在线调整可以增加覆盖面，但可能会影响心理安全。
Schwartz 轮是一种独特的干预措施，可以通过预注册教育为医疗保健学生提供支持。提出的五个"核心"和五个"情境调整"特征确定了为本科生实施轮次的组织的重要考虑因素。
