Grand Rounds Revisited: Some Comments on Current Practices

Can We Make Grand Rounds “Grand” Again?

“…9 Patients were no longer present, nor were they (or their attitudes, feelings, and social issues) the focus, as the diseases had taken precedence in the discussions. 1,5,8,10,18,20 This paradigm shift was noted in several editorials and in a 1982 questionnaire of chief residents, which found that patients were rarely or never present at grand rounds in 78% of institutions. 1 What prompted this change?…”

“…17 Participation increased, and when these rounds moved from the bedside to an auditorium, the traditional approach to grand rounds was created. 1,10,[17][18][19] It is not known who coined the term.…”

“…9 Patients were present during the resident's presentation or immediately after. 1,3,8,10 Senior physicians questioned the patient and observed any physical findings demonstrated by the resident. 1,3,10 After the patient exited, his or her problems were discussed in what was described as a ''free discussion between thinking men of widely different interests and experience'' that instilled character and inspired future physicians.…”

“…1,3,8,10 Senior physicians questioned the patient and observed any physical findings demonstrated by the resident. 1,3,10 After the patient exited, his or her problems were discussed in what was described as a ''free discussion between thinking men of widely different interests and experience'' that instilled character and inspired future physicians. [1][2][3]8,10,19 The patient, the ''theoretic focus of all clinic activity,'' remained the principal topic.…”

“…8 The literature also suggests that the relevance of grand rounds is declining. 1,5,7,[9][10][11][12] With decreasing attendance and a format that is drastically different from its original design, some have proposed forgoing the term ''grand rounds.'' 5,13,14 Several studies, surveys, and editorials have tried to explain the possible reasons for the declining relevance of grand rounds and identified different strategies to make them more effective, but to date no scholarly work has systematically aggregated this information.…”