LAUSR

Residents express mixed views about the educational value of bedside rounds. At Emory University, faculty were instructed to bedside round with their teams daily, and the authors then used focus groups to explore residents’ perspectives on the contextual factors influencing the educational value of rounds. They found four categories of modifiable factors—institutional factors, rounding structure, faculty behaviors, and educational content—and used these findings to develop bedside rounding recommendations and inform faculty development sessions. Residents echoed some findings from the literature, but they also provided rich, contextual descriptions explaining how factors could be modified to gain trainee buy-in regarding the educational value of bedside rounds. 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.