| An ethnographic study of attending rounds in general paediatrics: understanding the ritual. | |
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MedLine Citation:
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PMID: 20946480 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Teaching at the bedside during attending rounds is considered to be fundamental to medical education. We conducted an ethnographic case study to investigate such teaching in general paediatrics as a social phenomenon and to explore change over time in both the meaning of rounds and the context in which rounds take place. METHODS: We conducted a case study from January to August 2006 on a 22-bed general paediatric unit in an urban children's hospital and focused our observation on interns, senior residents and attending physicians. We observed the medical team during its normal activities on the study unit and conducted semi-structured interviews with a sample of attendings, interns and senior residents. We compiled a list of codes that emerged from patterns in the data and constructed a rich description of rounds according to the principles of inductive analysis. RESULTS: Four themes emerged from the data: (i) attending rounds are a pervasive and routine part of clinical education; (ii) interns, senior residents and attending physicians hold assumptions about what should happen on rounds; (iii) tension exists between interns', senior residents' and attending physicians' assumptions about bedside teaching during rounds and the reality imposed by contextual factors, and (iv) bedside teaching during rounds is impacted, but not prohibited, by contextual factors. CONCLUSIONS: Our case study provides evidence that bedside teaching during rounds is a pedagogical ideal entrenched in medical education. Participants readily acknowledged teaching at the bedside during rounds as something they perceived should happen, although, in actuality, it was infrequently achieved. This study revealed a telling inconsistency in language and behaviour: 'bedside rounds' was embedded in the participants' ordinary language, but the activity was not necessarily part of their ordinary behaviour. We propose that the practice of bedside teaching is best explained as a ritual. Considering bedside teaching as a ritual helps to explain why rounds are sacrosanct and helps to develop more appropriate expectations for rounds. |
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Authors:
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Dorene F Balmer; Christina L Master; Boyd F Richards; Janet R Serwint; Angelo P Giardino |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Medical education Volume: 44 ISSN: 1365-2923 ISO Abbreviation: Med Educ Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-15 Completed Date: 2011-02-24 Revised Date: 2011-05-27 |
Medline Journal Info:
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Nlm Unique ID: 7605655 Medline TA: Med Educ Country: England |
Other Details:
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Languages: eng Pagination: 1105-16 Citation Subset: IM |
Copyright Information:
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© Blackwell Publishing Ltd 2010. |
Affiliation:
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Department of Pediatrics, Columbia University Medical Centre, New York, New York, USA. db2595@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anthropology, Cultural Attitude of Health Personnel* Education, Medical, Graduate / methods* Humans Pediatrics / education* Teaching / methods*, organization & administration Teaching Rounds* |
| Comments/Corrections | |
Comment In:
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Med Educ. 2011 May;45(5):536; author reply 537
[PMID:
21486361
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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