A Pilot Study Using Nominal Group Technique to Assess Residents’ Perceptions of Successful Attending Rounds

Abstract

Ward attending rounds are fundamental for internal medicine residency training. An improved understanding of interns' and residents' perceptions of attending rounds should inform training programs and attending physicians. The aim of this study was to assess residents' perceptions of successful attending rounds. We convened two groups of interns and two groups of residents, to elicit their perceptions on attending rounds. Participants were recruited by e-mail and conference announcements from the 49 interns and 80 residents in the internal medicine and medicine-pediatrics residency programs. The nominal group technique (NGT) uses a structured group process to elicit and prioritize answers to a carefully articulated question. Seven interns (14%) identified 27 success factors and ranked attending approachability and enthusiasm and high quality teaching as most important. A second group of six (12%) interns identified 40 detractors and ranked having "mean attendings," receiving disrespectful comments, and too long or too short rounds as the most significant detractors. Nine (11%) residents identified 32 success factors and ranked attention to length of rounds, house staff autonomy, and establishing goals/expectations as the most important success factors. A second group of six (8%) residents identified 34 detractors and ranked very long rounds, interruptions and time constraints, and poor rapport between team members as the most significant detractors). Although there was some overlap in interns' and residents' perceptions of attending rounds, interns identified interpersonal factors as the most important factors; whereas residents viewed structural factors as most important. These findings should assist attending physicians improve the way they conduct rounds targeting both interns and residents needs.