Resident Perspectives Regarding Education on Attending Rounds.

Abstract

Introduction: An important component of internal medicine resident education is morning (attending) rounds. Effective aspects of medical education include involving all team members, minimizing distractions, asking questions, and having ready access to data, all of which may not be present during rounds. There is limited information on learner-centered rounds or resident perspectives about education during rounds. To inform a learner-centered approach to rounds, the investigators conducted a focus group study of Internal Medicine residents exploring their perceived strengths and weaknesses of rounds, and how rounds could be better used as a teaching tool.

Methods: Three 60-min focus groups were conducted with N = 21 postgraduate year 2/3 Internal Medicine Residents at Montefiore Medical Center in Bronx, NY, USA in 2021-2022. Two resident investigators led the focus groups using a semistructured interview guide. Questions included defining types of rounds, benefits and pitfalls of various rounding styles, their impact on resident education, and recommendations to improve education on morning rounds. The sessions were audio recorded, transcribed verbatim, and de-identified. Transcripts were analyzed through inductive thematic analysis.

Results: Rounding styles identified were bedside, table rounds, and a hybrid approach. Three themes emerged through analysis of the data: (1) A hybrid model offers an optimal balance of education; (2) full bedside rounds have unintended pitfalls; and (3) Attending preparation affects the quality of rounds.

Conclusions: Residents' perceptions of the education on attending rounds are impacted by both attending rounding style and advanced preparation. Our participants' insights could inform a rounding approach that optimizes both patient- and learner-centeredness.