The undergraduate virtual grand teaching ward round: Perceptions from the subcontinent.

Thushan Gooneratne, Mandika Wijeyaratne
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Abstract

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.

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本科生虚拟教学大查房:来自次大陆的看法。
背景 大查房是本科医学教育不可或缺的组成部分。Covid-19 妨碍了传统大查房(CWR)的进行,促使了 "虚拟 "大查房(VWR)的出现。限制解除后,未来的大查房是否仍应保持虚拟性?我们征求了本科生对这两种形式的看法,以探讨将 VWR 作为医学生教学查房的可行性。方法 我们的研究是在 2021 年 4 月至 2022 年 4 月期间进行的。在 2021 年 4 月至 11 月期间,每周一次的大查房被改为 VWR。限制解除后,又恢复为 CWR。所有患者均提供了知情同意书。利用智能手机创建了一个基于 Zoom 的安全在线平台,用于共享视听资料和患者讨论。在 VWR 和 CWR 阶段,对本科生进行了在线匿名反馈调查。结果 答复率为 71%(182/258)。在时间效率(p=0.03)、空间限制(p=0.01)、可听性提高(p=0.02)和参与讨论的机会增加(p=0.1)等方面,VWR 被认为比 CWR 更具优势。大多数学生(80%)认为,VWR 提供了一个更 "理想 "的大病房。在安全性(92%)、有效性(72%)、交流(85%)、信息可用性(84%)和培训机会(73%)方面,学生总体上更倾向于 VWR。同样,80% 的学生希望今后的查房能采用虚拟查房。结论 VWR 是一种创新方法。虽然不能替代床边教学,但它似乎更安全、更高效、更引人深思/讨论,也更令人满意。今后可采用 VWR 的成功要素,发展更理想的本科生大查房。
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