Jill A. Patton, DOAdvocate Lutheran General Hospital
Program Size: 31-100 residentsAcademic Setting: Community-BasedClinical Setting: Inpatient wards
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Our residents and student were frustrated that each rounding attending expected a different style of presentation on bedside teaching rounds. It takes 2-3 days before students and Interns know what is expected. The third year resident know the attending and can at times predict what is expected. Our program director’s team asked a few third residents to put together a brief checklist of what the medical student, intern or resident, which we will refer to as trainee, needs to prepare to present for bedside work rounds. This checklist of 6 items was then put on a laminated card for every trainee. During our orientation at the beginning of the year we review the checklist. It was also shared with faculty at our faculty meeting. Residents checklist was then linked to competencies and milestones allowing faculty to directly observe and provide feedback for the trainee in real time. We then created a Rounding Observation Form for the faculty to allow for instant assessment of performance that is milestone based for the trainee. After several direct observations we request the faculty make an entrustment judgment of the trainee.
We involved residents in the development of a bedside rounds check list. This check list we laminated and gave to every resident to carry in their pocket so they would know what to present on bedside rounds. Checklist items were linked the checklist to competency based Internal Medicine Milestones.
The faculty had trouble finding the tool in e-value on their smart phones initial so we provided paper forms and support staff documented their observations in E-value for them.
Faculty was trained at a faculty meeting. Descriptive directions are sent to faculty at the start of each rotation.
Bedside rounds is a learning experience where the supervising physician will tell Residents: “This is how you will be evaluated on bedside rounds”. The assessment areas are linked to competency based milestones. The supervising physician should only assess the items they observed. The intent is not to complete the assessment in one bedside encounter. This is meant for timely feedback of one or two assessments. The trainee will be assessed on multiple encounters as they continue to progress through the milestones to entrustment.
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