Abstract
BackgroundThe medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians’ tasks and relevant competences for conducting a medical ward round on the first day of professional work.MethodsA review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme.ResultsNine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork.ConclusionThe study is the first to picture ward round competences and related tasks in detail and to define an EPA “Conducting an internal medicine ward round” based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0697-y) contains supplementary material, which is available to authorized users.
Highlights
The medical ward round is a central but complex activity that is of relevance from the first day of work
Domains of internal medicine ward round competences as indicated by prior research The first research question put an emphasis on the identification of domains of competences indicated in prior research
We identified 12 domains of competences in the literature that were frequently linked to internal medicine ward rounds (Table 1)
Summary
The medical ward round is a central but complex activity that is of relevance from the first day of work. This paper aims to identify and describe physicians’ tasks and relevant competences for conducting a medical ward round on the first day of professional work. Ward rounds are characterized by collaborative clinical reasoning of physicians and nurses with regard to evidence-based patient care, physicians’ and nurses’ perspectives as well as patients’ social and emotional situation [2]. Apart from this, ward rounds constitute a valuable component in both undergraduate and graduate medical education that aims at imparting clinically relevant knowledge [4]. After their graduation, physicians are responsible for carrying out this complex task. Research reports that physicians struggle in overtaking this task and transitioning to the workplace’s demands successfully [5,6,7]
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