Department of Surgery, University of Colombo, 25, Kynsey Road, Colombo 08000, Sri Lanka.
Natl Med J India. 2024 Jan-Feb;37(1):32-34. doi: 10.25259/NMJI_429_2022.
Background Grand ward rounds are an integral component of undergraduate medical education. Covid-19 prevented the conduct of conventional grand ward rounds (CWRs) prompting a 'virtual' grand ward round (VWR). With restrictions lifted should future grand ward rounds remain virtual? Undergraduate perceptions on the two formats were sought to explore the feasibility of the VWR as a teaching ward round for medical students. Methods Our study was done during April 2021 to April 2022. The weekly grand ward round was converted to a VWR during April-November 2021. Following lifting of restrictions, it was reverted to a CWR. All patients provided informed consent. A Zoom-based, secure, online platform was created with the use of smartphones to share audiovisuals and patient discussions. An online anonymised feedback survey was conducted for undergraduates during both VWR and CWR phases. Results The response rate was 71% (182/258). VWR was considered more advantageous than the CWR in terms of time efficiency (p=0.03), space restrictions (p=0.01), improved audibility (p=0.02) and better opportunity to engage in discussions (p=0.1). Most students (80%) felt that the VWR provides a more 'ideal' grand ward. Overall preference was towards VWR across safety (92%), efficacy (72%), communication (85%), information availability (84%) and training opportunity (73%). Again 80% of students preferred future ward rounds to be virtual. Conclusions VWR is an innovative approach. While not a substitute for bedside teaching it appears safer, efficient, thought/discussion-provoking and more satisfactory. Successful elements of the VWR can be adopted in future, to develop a more ideal undergraduate grand ward round.
背景 大查房是本科医学教育的一个组成部分。Covid-19 阻止了常规大查房（CWR）的进行，促使了“虚拟”大查房（VWR）的出现。随着限制的解除，未来的大查房是否应该仍然采用虚拟形式？本研究旨在探索 VWR 作为医学生教学查房的可行性，为此我们征求了本科生对这两种形式的看法。
方法 我们的研究于 2021 年 4 月至 2022 年 4 月进行。2021 年 4 月至 11 月，每周的大查房改为 VWR。限制解除后，又恢复为 CWR。所有患者均提供了知情同意。使用智能手机创建了一个基于 Zoom 的安全在线平台，用于共享视听和患者讨论。在 VWR 和 CWR 阶段，我们对本科生进行了在线匿名反馈调查。
结果 回复率为 71%（182/258）。VWR 在时间效率（p=0.03）、空间限制（p=0.01）、改善可听度（p=0.02）和更好地参与讨论的机会（p=0.1）方面被认为比 CWR 更有优势。大多数学生（80%）认为 VWR 提供了更“理想”的大查房。在安全性（92%）、疗效（72%）、沟通（85%）、信息可用性（84%）和培训机会（73%）方面，学生普遍更喜欢 VWR。再次有 80%的学生希望未来的查房采用虚拟形式。
结论 VWR 是一种创新的方法。虽然它不能替代床边教学，但它似乎更安全、高效、能激发思考和讨论，并且更令人满意。VWR 的成功要素可以在未来被采用，以开发更理想的本科大查房。
