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Taking a Closer Look at Attending Rounds

Taking a Closer Look at Attending Rounds

Attending rounds has been a long-standing practice for internal medicine physicians, residents, and medical students to direct patient care, communicate with patients and families, and advance their medical education. The model of having senior physicians, trainees, and patients interact has existed for decades, but the features of these rounds have evolved dramatically in more recent years, explains Chad Stickrath, MD. “The format has shifted away from being conducted mostly at the bedside to taking place more frequently in conference rooms and hallways.” The Accreditation Council for Graduate Medical Education (ACGME) program requires that patient-based teaching include direct interaction between residents and attending physicians, bedside teaching, discussion of pathophysiology, and the use of current evidence in diagnostic and therapeutic decisions. The ACGME does not, however, provide additional specific guidelines on how to accomplish these requirements. The structure and content of contemporary attending rounds has not been well described in studies. “Some educators have expressed concerns about how patient communication and physical examination skills are being deemphasized,” adds Dr. Stickrath. Are Patient Rounds Meeting Goals? In a study published in JAMA Internal Medicine, Dr. Stickrath and colleagues sought to determine if current methods of patient rounds are meeting patient care and educational goals. The cross-sectional observational analysis was conducted at four teaching hospitals, involving 56 attending physicians and 279 trainees who treated 807 general medicine inpatients. The study group performed detailed observations of 90 rounds over a course of nearly 2 years.   According to results, most rounds consisted of an attending physician and several resident and student trainees, speaking with a median of nine patients during the course of about...
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