Improving resident physician interprofessional collaborative practice during bedside interdisciplinary rounds

Abstract

Significant gaps remain between current interprofessional education (IPE) and true interprofessional collaborative practice (IPCP). This study explores how resident physician teamwork behaviors on bedside interdisciplinary rounds are affected by a team-based pedagogical approach. In the context of interdependent interprofessional workflow and intentional teamwork teaching, we conducted a pre-post comparison study of bedside rounds teamwork behaviors of resident physicians at the beginning and at the end of a four-week rotation between July 2017 and May 2018. All 82 eligible residents during the study period enrolled in the study, making the participation rate 100%. Resident physicians performed 54% of predetermined teamwork behaviors at the beginning and 60% at the end of their rotation (P < 0.001). The most improved behaviors were inviting patient/family cross-check (38%–53%, p < 0.001), avoiding medical jargon (85%–98%, P < 0.001), proposing the plan for the day after other inputs (84%–95%, p < 0.001), and asking permission to enter the room (42%–54%, p = 0.002). Behaviors performed frequently included introducing interdisciplinary staff by name/role and speaking directly to patients. Rarely performed behaviors included introducing self, proposing discharge plans on non-discharge days, and assigning tasks to team members. Our findings suggest that an educational approach based on interdependent work and explicit teamwork feedback can improve resident physician IPCP. This study highlights the importance of intentionally constructing clinical learning environments to achieve effective interprofessional learning.