Improving ward round skills

Krautter, Markus; Koehl-Hackert, Nadja; Nagelmann, Lars; Jünger, Jana; Norcini, John J.; Tekian, Ara; Nikendei, Christoph

doi:10.3109/0142159x.2014.909585

Cited by 26 publications

(17 citation statements)

References 21 publications

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“…On-ward supervision has already proven to be well accepted in preliminary work [17] and is also effective in improving ward round skills [53]. In the present study, video feedback was perceived to enhance teacher-directed feedback.…”

Section: Discussionmentioning

confidence: 59%

“…To determine the added value of filming patient interactions, future research should aim to objectively assess the added benefit to the supervision programme [17, 53] when integrating video-feedback, in terms of a justification study [59]. Moreover, it is unclear whether the benefits of video-based, on-ward supervision are higher for some skills or procedures than for others.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the present study aimed to examine feasibility, obstacles to implementation and participants’ first impressions. However, the underlying supervision model of the present study has previously been proven to be effective in a controlled study of conducting ward rounds [53]. Further controlled studies are needed to investigate the extent of the benefits of video-based, on-ward feedback.…”

Section: Discussionmentioning

confidence: 97%

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Video-based on-ward supervision for final year medical students

et al. 2015

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BackgroundConstructive feedback is an essential element of the educational process, helping trainees reach their maximum potential and increasing their skill level. Video-based feedback has been described as highly effective in various educational contexts. The present study aimed to evaluate the feasibility and acceptability of video-based, on-ward supervision for final year students in a clinical context with real patients.MethodsNine final year medical students (three male, six female; aged 25.1 ± 0.7 years) and eight patients (five male, three female; aged 59.3 ± 16.8 years) participated in the pilot study. Final year students performed routine medical procedures at bedside on internal medicine wards at the University of Heidelberg Medical Hospital. Students were filmed and were under supervision. After performing the procedures, an oral feedback loop was established including student, patient and supervisor feedback on communicative and procedural aspects of skills performed. Finally, students watched their video, focusing on specific teachable moments mentioned by the supervisor. Written evaluations and semi-structured interviews were conducted that focused on the benefits of video-based, on-ward supervision. Interviews were analysed qualitatively, using open coding to establish recurring themes and overarching categories to describe patients’ and students’ impressions. Descriptive, quantitative analysis was used for questionnaire data.ResultsSupervised, self-chosen skills included history taking (n = 6), physical examination (n = 1), IV cannulation (n = 1), and ECG recording (n = 1). The video-based, on-ward supervision was well accepted by patients and students. Supervisor feedback was rated as highly beneficial, with the video material providing an additional opportunity to focus on crucial aspects and to further validate the supervisor’s feedback. Students felt the video material would be less beneficial without the supervisor’s feedback. The setting was rated as realistic, with filming not influencing behaviour.ConclusionVideo-based, on-ward supervision may be a powerful tool for improving clinical medical education. However, it should be regarded as an additional tool in combination with supervisors’ oral feedback. Acceptance was high in both students and patients. Further research should address possibilities of efficiently combining and routinely establishing these forms of feedback in medical education.

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Section: Discussionmentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

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Video-based on-ward supervision for final year medical students

et al. 2015

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“…A study has identified deficits in final‐year medical students’ ward round competencies . Teaching ward round competencies to medical students and newly graduated doctors through simulation and observed practice has been explored, but this is time and resource intensive . A number of teams have developed ward‐round checklists, and have demonstrated their value for improving care and safety on ward rounds, but a key limitation of this is the resistance to a ‘checklist approach’ to medicine .…”

Section: Introductionmentioning

confidence: 99%

Ward rounds: can an aide‐memoire help new doctors?

Pearce

Redman

Gajebasia

et al. 2018

The Clinical Teacher

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In the initial survey (2015), 42% (n = 19) of the 45 FY1s in NLaG responded: 84% (n = 16) reported conducting ward rounds alone twice or more each week, with 5% (n = 1) feeling prepared and 89% (n = 17) feeling unprepared to do so. In the second survey (2016), following the introduction of the aide-memoire, 52% (n = 25) of the 48 FY1s responded: 32% (n = 7) reported feeling prepared with the aide-memoire (a 27% increase from 2015). There was also a statistically significant increase in the frequency with which they reported considering three of 13 important aspects of care: nutrition, mobility and discharge planning. There are no studies exploring the frequency with which newly graduated doctors conduct ward rounds alone DISCUSSION: The FY1s were regularly conducting ward rounds alone, and felt unprepared for this. An aide-memoire is a low-cost intervention with some value in improving preparedness, and could be further developed and used elsewhere.

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“…As the interviewed final-year medical students perceived on-ward teaching as an important resource to improve their knowledge, team integration, and enthusiasm for work, these should serve as linchpins for curricular changes. Implemented guidance, supervised on-ward teaching, 27 , 46 personal assumption of clinical responsibilities, 47 and the training of relevant clinical skills prior the start of the final year 23 , 48 have been previously shown to be essential parts in final-year medical education. However, effective team communication and conflict management trainings 36 could additionally empower students to deal with conflict.…”

Section: Discussionmentioning

confidence: 99%

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

Moczko¹,

Bugaj²,

Herzog³

et al. 2016

AMEP

Self Cite

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ObjectivesThis study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace.MethodsIn this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years) were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed.ResultsStudents’ statements regarding burdens and dealing with stress were classified into four main categories: A) perceived stressors and provoking factors, B) stress-induced consequences, C) personal and external resources for preventing and dealing with stress, and D) final-year students’ suggestions for workplace improvement.ConclusionFinal-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically.

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Improving ward round skills

Abstract: RESULTS provide evidence that the presented program is a feasible and efficient tool for teaching ward round skills at the bedside. Further research should focus on cost effectiveness compared to alternative models.

Cited by 26 publications

References 21 publications

Video-based on-ward supervision for final year medical students

Video-based on-ward supervision for final year medical students

Ward rounds: can an aide‐memoire help new doctors?

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

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Improving ward round skills

Abstract: RESULTS provide evidence that the presented program is a feasible and efficient tool for teaching ward round skills at the bedside. Further research should focus on cost effectiveness compared to alternative models.

Cited by 26 publications

References 21 publications

Video-based on-ward supervision for final year medical students

Video-based on-ward supervision for final year medical students

Ward rounds: can an aide‐memoire help new doctors?

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students&rsquo; needs

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Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs