Teaching a 'good' ward roundWard rounds are a vital part of hospital medicine and junior doctors play a key role in their delivery. Despite the importance of ward rounds to patient care and experience, we believe that junior doctors may lack the training and skills to carry them out most effectively. We designed a simulation-based training session focusing on ward round skills themed to key patient safety issues and have delivered the training to over 100 learners (medical students and foundation year one doctors). Few learners had any prior training in ward rounds. The session was highly valued by all participants and surveys completed both before and after the session showed statistically signifi cant improvements in confi dence in leading and documenting ward rounds. In addition, 94% of fi nal year medical students and 93% of doctors felt such training should be included in the undergraduate curriculum. We believe there is a current gap in training around ward round skills and would strongly encourage simulation-based ward round training to be developed for undergraduates. Further sessions following qualifi cation may then consolidate and develop ward round skills adapted to the level of the doctor. KEYWORDS: Ward round, simulation, junior doctors, education IntroductionAs the predominant point of doctor-patient interaction, ward rounds can signifi cantly infl uence patient experience as well as ensure high-quality, safe care for patients. 1,2 The joint RCP/ RCN publication Ward rounds in medicine: principles for best practice 3 highlights the signifi cant variation in terms of current organisation and practice of ward rounds. It recommends rounds that have clear structure and strong leadership for maximum effectiveness. Most consultant job plans allow for only two ward rounds a week, so many rounds are led by junior doctors.Whether leading or participating, the roles that junior doctors play in ward rounds are central to their delivery. In return, ward rounds offer many teaching and learning opportunities. 4 In recent years ward rounds have become both time pressured and discharge focused, so additional effort is required to ensure that their educational potential is not lost. Medical students fi rst encounter ward rounds during undergraduate placements but, to our knowledge, receive little in the way of formal training and may lack essential ward-round skills at qualifi cation. 5 As postgraduates, communication skills and patient safety feature heavily in foundation curricula, but the ability to lead or participate in a structured, safe, ward round is not specifi cally referred to. 6 Hectic and time-pressured situations can compromise quality and increase the chance of error. In ward rounds this could translate into hurried, unsafe practice in which key elements are missed, eg it has been demonstrated that less thorough ward rounds can lead to poorer outcome in surgical patients. 7 Just as importantly, chaotic rounds are likely to have a negative effect on patient experience. Medical ward safety checklists ...

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Backround Ward rounds are complex clinical activities which are crucial in providing high quality patient-centred healthcare. They are intricately linked to patient safety, patient experience and clinical outcomes. The Royal College of Physicians/Royal College of Nursing joint publication Ward Rounds in Medicine, highlighted the need for structured multidisciplinary rounds, based on current best practice and emphasised the need for robust training strategies.1 The QWRP is a collaborative project involving three acute hospital sites, Brighton and Sussex Medical School (BSMS), University of Brighton’s School of Health Sciences and Pharmacy, supported by an educational grant from Health Education Kent, Surrey and Sussex (HEKSS). Our aim is to develop an integrated educational ward round programme which can be delivered across the HEKSS region. Methodology Building on previous work conducted at our collaborating hospital trusts we have established a collaborative working group to develop a generic ward round educational programme. The QWRP team are designing a low technology simulation course and e-learning training programme in multidisciplinary rounds for final year medical students, foundation doctors, student nurses and pre-registration pharmacists. Results Pilot courses at two trusts have delivered themed-ward round simulation training to 142 participants. Our preliminary data demonstrates that confidence levels in leading rounds was significantly improved in foundation doctors and undergraduate students. Feedback has been overwhelmingly positive, with 93% rating the session as excellent or very good and the majority recommending it should be a mandatory part of training. Nursing students and pharmacists indicated the training was an excellent means of restoring their importance in the ward round process. We will present further data as the project develops. Potential impact Low technology ward round simulation-based education is well received and improves confidence levels in learners. It is practical, transferrable and may enhance multiprofessional learning for the benefit of patient care. References Royal College of Physicians/Royal College of Nursing. Ward rounds in medicine: principles for best practice. Royal College of Physicians 2012.

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