The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Original Article
Impact of Rounding Setting on the Quality of Medical Trainee Experience
Abstract
Objectives: Hospital rounding practices have shifted away from being conducted at the patient’s bedside to favor rounding in workrooms. Prior studies assessing learner attitudes toward bedside rounds largely focused on its educational value for residents, with less attention paid to medical students or other relevant domains in the learner experience. We sought to comprehensively capture resident and medical student perceptions of bedside rounds and their effects on various key domains, as well as elucidate common barriers to bedside rounding.Methods: All residents and medical students who participated in teaching rounds in Internal Medicine at one large academic medical center in 2024 were invited to complete a voluntary anonymous survey. Participants also had the opportunity to partake in structured qualitative interviews, which were analyzed using a constructivist grounded theory approach to examine learners’ perspectives on the impact of rounding setting on each of the key domains.
Results: Seventy-seven residents and 112 medical students completed the survey (response rates of 45% and 39%, respectively), and 18 interviews were conducted (10 residents and 8 medical students). Overall, both residents and medical students had a majority preference for either table or hybrid rounding over bedside rounding in nearly every domain.
Conclusions: Medical students overall identified more positive aspects of bedside rounding, particularly in regard to its potential to introduce opportunities for teaching or improved patient care. These findings may help institutions develop guidelines and faculty development practices for improving learner receptivity and engagement with bedside rounds.
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References
1. Chan SJ, Archibald HL, Conner SM. NET Rounding: a novel approach to efficient and effective rounds for the modern clinical learning environment. BMC Med Educ 2022;22:600.
2. Stickrath C, Noble M, Prochazka A, et al. Attending rounds in the current era: what is and is not happening. JAMA Intern Med 2013;173:1084–1089.
3. McNeil C, Muck A, McHugh P, et al. Bedside rounds versus board rounds in an emergency department. Clin Teach 2015;12:94–98.
4. Crumlish CM, Yialamas MA, McMahon GT. Quantification of bedside teaching by an academic hospitalist group. J Hosp Med 2009;4:304–307.
5. Harrison R, Allen E. Teaching internal medicine residents in the new era. Inpatient attending with duty-hour regulations. J Gen Intern Med 2006;21:447–452.
6. Reed DA, Levine RB, Miller RG, et al. Impact of duty hour regulations on medical students' education: views of key clinical faculty. J Gen Intern Med 2008;23:1084–1089.
7. McGee S. A piece of my mind. Bedside teaching rounds reconsidered. JAMA 2014;311: 1971–1972.
8. Bryne A, Wiese J. Using Bedside Rounds to Change Culture. Med Clin North Am 2020;104: 739–750.
9. Miller M, Johnson B, Greene HL, et al. An observational study of attending rounds. J Gen Intern Med 1992;7:646–648.
10. Gonzalo JD, Chuang CH, Huang G, et al. The return of bedside rounds: an educational intervention. J Gen Intern Med 2010;25:792–798.
11. Ramirez J, Singh J, Williams AA. Patient Satisfaction with Bedside Teaching Rounds Compared with Nonbedside Rounds. South Med J 2016;109:112–115.
12. Shih AF, Addo-Tabiri NO, Sofair AN. Patients' Perceptions of Bedside Rounding. South Med J 2018;111:281–287.
13. Merchant NB, Federman DG. Bedside Rounds Valued But Not Preferred: Perceptions of Internal Medicine Residents and Attending Physicians in a Diverse Academic Training Program. South Med J 2017;110:531–537.
14. Ratelle JT, Gallagher CN, Sawatsky AP, et al. The Effect of Bedside Rounds on Learning Outcomes in Medical Education: A Systematic Review. Acad Med 2022;97:923–930.
15. Spicer JO, Rockney D, Massart A. Optimizing the Educational Value of Bedside Rounds by Exploring Perceptions of Internal Medicine Residents. South Med J 2022;115:294–300.
16. Monash B, Najafi N, Mourad M, et al. Standardized Attending Rounds to Improve the Patient Experience: A Pragmatic Cluster Randomized Controlled Trial. J Hosp Med 2017;12: 143–149.
17. Quilligan S. Learning clinical communication on ward-rounds: an ethnographic case study. Med Teach 2015;37:168–173.
18. Chand DV. Observational study using the tools of lean six sigma to improve the efficiency of the resident rounding process. J Grad Med Educ 2011;3:144–150.
19. Feinman M, Hsu ATW, Taylor S, et al. Cutting the fat: Utilizing LEAN methodology to improve rounding efficiency of surgical residents. Am J Surg 2022;223: 1100–1104.
20. Balch H, Gradick C, Kukhareva PV, et al. Association of Mobile Workstations and Rounding-in-Flow with Resident Efficiency: A Controlled Study at an Academic Internal Medicine Department. J Gen Intern Med 2022;37:3700–3706.
