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Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions
Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement. To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and as...
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| Published in: | Advances in medical education and practice 2020-01, Vol.11, p.921-929 |
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| cited_by | cdi_FETCH-LOGICAL-c545t-781e6838147068d43550e348d6eb6c05d96725ce15091e055028349dc0660d523 |
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| cites | cdi_FETCH-LOGICAL-c545t-781e6838147068d43550e348d6eb6c05d96725ce15091e055028349dc0660d523 |
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| container_title | Advances in medical education and practice |
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| creator | Shields, Helen M Honan, James P Goldsmith, Jeffrey D Madan, Rachna Pelletier, Stephen R Roy, Christopher L Wu, Lindsey C |
| description | Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement.
To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact.
We conducted a randomized, controlled trial to evaluate the efficacy of our intervention.
Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group.
A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases.
Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses.
Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p |
| doi_str_mv | 10.2147/AMEP.S277008 |
| format | article |
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To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact.
We conducted a randomized, controlled trial to evaluate the efficacy of our intervention.
Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group.
A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases.
Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses.
Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p<0.003). Residents rated morning bedside rounds with the experimental attendings as significantly more worthwhile compared to rounds with the control group attendings (p=0.009).
Our study findings highlight the benefits of a one-hour intervention to teach faculty a method of asking questions during bedside rounds. This educational strategy had the positive outcome of including significantly more resident voices at the bedside. Residents who rounded with attendings in the experimental group were more likely to "strongly agree" that bedside rounds were "worthwhile".</description><identifier>ISSN: 1179-7258</identifier><identifier>EISSN: 1179-7258</identifier><identifier>DOI: 10.2147/AMEP.S277008</identifier><identifier>PMID: 33299375</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Analysis ; asking questions ; bedside rounds ; clinical reasoning ; Education ; Evidence-based medicine ; Hospitalists ; Hospitals ; Internal medicine ; Leadership ; Nurses ; Original Research ; Patients ; Pharmacists ; randomized controlled trial ; Teaching methods ; teaching strategies ; Womens health</subject><ispartof>Advances in medical education and practice, 2020-01, Vol.11, p.921-929</ispartof><rights>2020 Shields et al.</rights><rights>COPYRIGHT 2020 Dove Medical Press Limited</rights><rights>2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Shields et al. 2020 Shields et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c545t-781e6838147068d43550e348d6eb6c05d96725ce15091e055028349dc0660d523</citedby><cites>FETCH-LOGICAL-c545t-781e6838147068d43550e348d6eb6c05d96725ce15091e055028349dc0660d523</cites><orcidid>0000-0003-0457-9606</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2470528767/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2470528767?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33299375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shields, Helen M</creatorcontrib><creatorcontrib>Honan, James P</creatorcontrib><creatorcontrib>Goldsmith, Jeffrey D</creatorcontrib><creatorcontrib>Madan, Rachna</creatorcontrib><creatorcontrib>Pelletier, Stephen R</creatorcontrib><creatorcontrib>Roy, Christopher L</creatorcontrib><creatorcontrib>Wu, Lindsey C</creatorcontrib><title>Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions</title><title>Advances in medical education and practice</title><addtitle>Adv Med Educ Pract</addtitle><description>Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement.
To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact.
We conducted a randomized, controlled trial to evaluate the efficacy of our intervention.
Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group.
A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases.
Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses.
Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p<0.003). Residents rated morning bedside rounds with the experimental attendings as significantly more worthwhile compared to rounds with the control group attendings (p=0.009).
Our study findings highlight the benefits of a one-hour intervention to teach faculty a method of asking questions during bedside rounds. This educational strategy had the positive outcome of including significantly more resident voices at the bedside. Residents who rounded with attendings in the experimental group were more likely to "strongly agree" that bedside rounds were "worthwhile".</description><subject>Analysis</subject><subject>asking questions</subject><subject>bedside rounds</subject><subject>clinical reasoning</subject><subject>Education</subject><subject>Evidence-based medicine</subject><subject>Hospitalists</subject><subject>Hospitals</subject><subject>Internal medicine</subject><subject>Leadership</subject><subject>Nurses</subject><subject>Original Research</subject><subject>Patients</subject><subject>Pharmacists</subject><subject>randomized controlled trial</subject><subject>Teaching methods</subject><subject>teaching strategies</subject><subject>Womens health</subject><issn>1179-7258</issn><issn>1179-7258</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1vEzEQhlcIRKvSG2dkiQMcSPDH-utCtYoKRCoC2nC2vPZs6nZjl_UGBL8epwmlAeyDR-N3ntE7mqp6SvCUklq-bj6cfppeUCkxVg-qQ0KknkjK1cN78UF1nPMVLqfWjBL9uDpgjGrNJD-svs8zavJ1iEv0eQ15DClmlCI6T-voM7JoAdZd2rYHdHEd-v4ENejcRp9W4Sd4NEtxHFLfl3AxBNujMaF5dAPYDKgZR4i-oPOLf3o8qR51ts9wvHuPqi9vTxez95Ozj-_ms-Zs4njNx4lUBIRiqnjFQvmacY6B1coLaIXD3GtRLDogHGsCuPxSxWrtHRYCe07ZUTXfcn2yV-ZmCCs7_DDJBnObSMPS2GEMrgdDaNe2gnnqO1UL2VpqLW-lAKeha29Zb7asm3W7Au-geLf9HnT_J4ZLs0zfjJQUK6UL4OUOMKSvm0mYVcgO-t5GSOtsaC00VpowVaTP_5JepfUQy6iKSmJOlRTyj2ppi4EQu1T6ug3UNKLmNZFcb1jT_6jK9bAKLkXoQsnvFbzaFrgh5TxAd-eRYLPZO7PZO7PbuyJ_dn8ud-LfW8Z-AVRH0HQ</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Shields, Helen M</creator><creator>Honan, James P</creator><creator>Goldsmith, Jeffrey D</creator><creator>Madan, Rachna</creator><creator>Pelletier, Stephen R</creator><creator>Roy, Christopher L</creator><creator>Wu, Lindsey C</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove</general><general>Dove Medical Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0457-9606</orcidid></search><sort><creationdate>20200101</creationdate><title>Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions</title><author>Shields, Helen M ; Honan, James P ; Goldsmith, Jeffrey D ; Madan, Rachna ; Pelletier, Stephen R ; Roy, Christopher L ; Wu, Lindsey C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c545t-781e6838147068d43550e348d6eb6c05d96725ce15091e055028349dc0660d523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Analysis</topic><topic>asking questions</topic><topic>bedside rounds</topic><topic>clinical reasoning</topic><topic>Education</topic><topic>Evidence-based medicine</topic><topic>Hospitalists</topic><topic>Hospitals</topic><topic>Internal medicine</topic><topic>Leadership</topic><topic>Nurses</topic><topic>Original Research</topic><topic>Patients</topic><topic>Pharmacists</topic><topic>randomized controlled trial</topic><topic>Teaching methods</topic><topic>teaching strategies</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shields, Helen M</creatorcontrib><creatorcontrib>Honan, James P</creatorcontrib><creatorcontrib>Goldsmith, Jeffrey D</creatorcontrib><creatorcontrib>Madan, Rachna</creatorcontrib><creatorcontrib>Pelletier, Stephen R</creatorcontrib><creatorcontrib>Roy, Christopher L</creatorcontrib><creatorcontrib>Wu, Lindsey C</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest_Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Advances in medical education and practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shields, Helen M</au><au>Honan, James P</au><au>Goldsmith, Jeffrey D</au><au>Madan, Rachna</au><au>Pelletier, Stephen R</au><au>Roy, Christopher L</au><au>Wu, Lindsey C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions</atitle><jtitle>Advances in medical education and practice</jtitle><addtitle>Adv Med Educ Pract</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>11</volume><spage>921</spage><epage>929</epage><pages>921-929</pages><issn>1179-7258</issn><eissn>1179-7258</eissn><abstract>Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement.
To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact.
We conducted a randomized, controlled trial to evaluate the efficacy of our intervention.
Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group.
A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases.
Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses.
Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p<0.003). Residents rated morning bedside rounds with the experimental attendings as significantly more worthwhile compared to rounds with the control group attendings (p=0.009).
Our study findings highlight the benefits of a one-hour intervention to teach faculty a method of asking questions during bedside rounds. This educational strategy had the positive outcome of including significantly more resident voices at the bedside. Residents who rounded with attendings in the experimental group were more likely to "strongly agree" that bedside rounds were "worthwhile".</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>33299375</pmid><doi>10.2147/AMEP.S277008</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0457-9606</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Advances in medical education and practice, 2020-01, Vol.11, p.921-929 |
| issn | 1179-7258 1179-7258 |
| language | eng |
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| source | Taylor & Francis Open Access; Publicly Available Content Database; PubMed Central |
| subjects | Analysis asking questions bedside rounds clinical reasoning Education Evidence-based medicine Hospitalists Hospitals Internal medicine Leadership Nurses Original Research Patients Pharmacists randomized controlled trial Teaching methods teaching strategies Womens health |
| title | Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions |
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