Medical Student Participation in Patient- and Family-Centered Rounding: A National Survey of Pediatric Clerkships

• Published in: Academic pediatrics 2019-07, Vol.19 (5), p.549-554
• Main Authors: Trost, Margaret J., Potisek, Nicholas M., Seltz, L. Barry, Rudnick, Melanie, Mamey, Mary Rose, Long, Michele, Quigley, Patricia D.
• Format: Article
• Language: English
• Subjects: Clinical Clerkship; Curriculum; Education, Medical, Graduate; Humans; medical student education; patient- and family-centered rounding; Patient-Centered Care; Pediatrics - education; Teaching Rounds
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2018.12.010

Pediatrics rotations may be medical students’ only experience with patient- and family-centered rounding (PFCR). It is unclear how students participate in or are prepared for PFCR. We surveyed national pediatrics clerkships to determine the prevalence of PFCR and the proportion providing orientation in order to inform a needs assessment for PFCR orientation. A 5-item peer-reviewed survey was distributed to the Council on Medical Student Education in Pediatrics (COMSEP) membership as part of a larger survey in 2017. Institutional differences among programs performing PFCR were compared using chi-square and t-tests. Responses to 1 open-ended question were coded and grouped into broad categories using content analysis. The full COMSEP survey received answers from 190 participants representing 103 medical schools. Our questions received 174 responses representing 94 schools (98 training sites) and had an 85% (83/98) prevalence of student PFCR participation. Although most (n = 108; 85%) reported that their students received PFCR orientation, half (n = 62; 49%) considered orientation “informal,” and only 2 reported using published curricula. After didactics, the most common orientation materials were handouts (n = 33; 26%), videos (n = 13; 10%), and role play (n = 7; 6%). Orientation was most commonly initiated at the start of clerkship (n = 62; 49%) by clerkship administration (n = 38; 30%), but 20% (n = 26) reported resident-led orientation. Qualitative responses (n = 98) were coded and organized into 4 themes; the greatest perceived challenges for medical students on PFCR were communication and anxiety. Although most students participate in and receive orientation to PFCR, there is wide variability in the content, timing, and administration of orientation. A nationally disseminated, evidence-based orientation curriculum may reduce educational variability and better prepare students for PFCR.