The neverending IM rounds debate – what is the best style?

I could stop with one sentence – there are several styles that work.  Let me explain. Internal medicine rounds have several goals.  First, we owe our patients the best diagnostic evaluation and then the best care. We owe our patients careful explanations of the day’s plan, and the overall plan.  Too often we have to break bad news. But we also have an obligation to help our learners grow.  They want to understand what we are doing and why we are doing it. Our group published an important paper Using Cognitive Mapping to Define Key Domains for Successful Attending Rounds  While the paper and methodology may seem complex, the results are clear: Overall, cognitive maps were similar between faculty and learners (not shown), but priorities differed. While faculty believed “being approachable” and “bedside manner” were the most important attributes, learners placed the highest value on “sharing attending’s thought processes.” This phrase differs from the transfer of knowledge alone. Residents and medical students want to understand how experienced physicians arrive at their decisions. What our learners desired correlates with the recent strong emphasis on clinical reasoning in the educational literature. We believe that rounding has multiple goals.  Thus when developing a rounding style, we should consider the above paragraph and also an explicit description of the dimensions: After examination of the attributes within distinct clusters, the cluster ...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs