Original Article

Optimizing the Educational Value of Bedside Rounds by Exploring Perceptions of Internal Medicine Residents

Authors: Jennifer O. Spicer, MD, MPH, Danica Rockney, MD, Annie Massart, MD

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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References

1. Gonzalo JD, Heist BS, Duffy BL, et al. The value of bedside rounds: a multicenter qualitative study. Teach Learn Med 2013;25:326–333.
 
2. Gonzalo JD, Masters PA, Simons RJ, et al. Attending rounds and bedside case presentations: medical student and medicine resident experiences and attitudes. Teach Learn Med 2009;21:105–110.
 
3. 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.
 
4. Miller M, Johnson B, Greene HL, et al. An observational study of attending rounds. J Gen Intern Med 1992;7:646–648.
 
5. Shoeb M, Khanna R, Fang M, et al. Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies. J Hosp Med 2014;9:239–243.
 
6. Rabinowitz R, Farnan J, Hulland O, et al. Rounds today: a qualitative study of internal medicine and pediatrics resident perceptions. J Grad Med Educ 2016;8:523–531.
 
7. Tariq M, Motiwala A, Ali SU, et al. The learners’ perspective on internal medicine ward rounds: a cross-sectional study. BMC Med Educ 2010;10:53.
 
8. Williams KN, Ramani S, Fraser B, et al. Improving bedside teaching: findings from a focus group study of learners. Acad Med 2008;83:257–264.
 
9. Gonzalo JD, Chuang CH, Huang G, et al. The return of bedside rounds: an educational intervention. J Gen Intern Med 2010;25:792–798.
 
10. McNeil C, Muck A, McHugh P, et al. Bedside rounds versus board rounds in an emergency department. Clin Teach 2015;12:94–98.
 
11. Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE guide No. 131. Med Teach 2020;42:846–854.
 
12. Gonzalo JD, Heist BS, Duffy BL, et al. Identifying and overcoming the barriers to bedside rounds: a multicenter qualitative study. Acad Med 2014; 89:326–334.
 
13. Wang-Cheng RM, Barnas GP, Sigmann P, et al. Bedside case presentations: why patients like them but learners don’t. J Gen Intern Med 1989;4:284–287.
 
14. Shih AF, Addo-Tabiri NO, Sofair AN. Patients’ perceptions of bedside rounding. South Med J 2018;111:281–287.
 
15. Solomon JM, Bhattacharyya S, Ali AS, et al. Randomized study of bedside vs hallway rounding: neurology rounding study. Neurology 2021;97:434–442.
 
16. Ramani S, Orlander JD, Strunin L, et al. Whither bedside teaching? A focus-group study of clinical teachers. Acad Med 2003;78:384–390.