Pediatric Residents’ Perceptions of Family-Centered Rounds as Part of Postgraduate Training

Abstract

Concerns regarding discomfort, attending approach and efficiency are potential barriers to residents' full acceptance of FCRs that should be addressed to improve the efficacy of postgraduate pediatric training.

Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit

“…The initial concerns voiced by our CTICU staff, as well as in published reports, regarding privacy issues, increasing parental anxiety, increasing duration of rounds, decreasing teaching during rounds, and concerns for parents' understanding of complex discussions [8][9][10][11] were not found to be true in our experience. Our findings are more consistent with those of Kuo et al, 13 who reported that family participation during rounds was associated with higher parental satisfaction, improved and consistent transfer of medical information, discussion of care plan, and participation in decision making; and Phipps et al, 10 who reported that parental presence during rounds did not inhibit teaching.…”

“…Some concerns voiced by staff regarding inclusion of parents during rounds include privacy issues, increasing parents' anxiety, increasing duration of rounds, decreasing teaching during rounds, and concerns for parents' understanding of complex discussions. [8][9][10][11] Phipps et al, 10 in an observational study, showed that parental presence during rounds did not inhibit teaching during rounds, although admittedly the data on this topic are controversial. Cameron et al, 12 in a prospective, observational, and survey-based study, showed that 40% of attending physicians limited their teaching during rounds to avoid exposing the knowledge gaps among house staff.…”

Improving Trainee Education During Family-Centered Rounds: A Resident’s Perspective

“…1 Literature on trainee perception of FCR universally cites fear of appearing less knowledgeable in front of patients and families as a barrier to didactic teaching on rounds. 2,3 This fear may lead trainees to forgo asking questions or offering answers to those posed by attending physicians, which results in suboptimal discussion about patient management. 2,3 In addition, fear of sharing sensitive patient information on FCR also serves as a barrier because trainees attempt to balance the emotional needs of patients and families with the need for frank clinical discussion.…”

“…2,3 This fear may lead trainees to forgo asking questions or offering answers to those posed by attending physicians, which results in suboptimal discussion about patient management. 2,3 In addition, fear of sharing sensitive patient information on FCR also serves as a barrier because trainees attempt to balance the emotional needs of patients and families with the need for frank clinical discussion. 2,4 Anecdotally, this is particularly true when it comes to discussion of appropriate differential diagnoses, especially when a difficult diagnosis such as malignancy is possible.…”

“…2,3 In addition, fear of sharing sensitive patient information on FCR also serves as a barrier because trainees attempt to balance the emotional needs of patients and families with the need for frank clinical discussion. 2,4 Anecdotally, this is particularly true when it comes to discussion of appropriate differential diagnoses, especially when a difficult diagnosis such as malignancy is possible. These fears often lead to a modified presentation of the patient's clinical picture, with more emphasis placed on patient and family comfort than trainee education.…”