Abstract
BackgroundTraining to be a doctor and caring for patients are recognized as being stressful and demanding. The wellbeing of healthcare professionals impacts upon the wellbeing and care of patients. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance communication and compassion, and have since been widely adopted as a way of fostering compassion. The continuum of education suggests that medical students need to develop these attributes in conjunction with resilience and maintaining empathy. The benefits of SCRs in fostering this development in medical students is unexplored.The objective of this study was to examine the potential of SCRs within the undergraduate curriculum.MethodsTwo student–focused SCRs were piloted at a major medical school. The sessions were based on the current format implemented across the US and UK: a presentation of cases by a multidisciplinary panel followed by an open discussion with the audience. Participants were asked to complete an evaluative questionnaire immediately following the sessions. Seven students took part in a focus group to explore their views on the SCR. Data sets were examined using descriptive statistics and thematic analysis.ResultsFeedback was obtained from 77 % (258/334) Year 5 and 37 % (126/343) Year 6 students. Mean student ratings of the session on a five-point scale, where 1 = poor and 5 = exceptional, were 3.5 (Year 5) and 3.3 (Year 6). Over 80 % of respondents either agreed or strongly agreed that the presentation of cases was helpful and gave them insight into how others feel/think about caring for patients. Eighty percent said they would attend a future SCR and 64 % believed SCRs should be integrated into the curriculum. Focus group participants felt SCRs promoted reflection and processing of emotion. Students identified smaller group sizes and timing in the curriculum as ways of improving SCRs.ConclusionStudents were positive about SCRs, preferring them to their current reflective practice assignments. Whether this results in sustained benefits to trainee doctors is yet to be explored. Consideration is given to overcoming the challenges that were encountered, such as optimal timing and participation. Staff training and costs are potential obstacles to adoption.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0762-6) contains supplementary material, which is available to authorized users.
Highlights
Training to be a doctor and caring for patients are recognized as being stressful and demanding
This study examines the applicability of Schwartz Centre Rounds (SCR) to medical schools, identifying whether it is possible to extrapolate the reflective, supportive culture that they foster to the undergraduate setting
The difference in rating between years was non-significant (NS). Combining students from both years who responded to the questionnaire, 80 % (292/365) said they would attend a future SCR and 64 % (235/366) thought that SCRs should be integrated into the medical school curriculum (Year 5: Year 6 p = NS) (Fig. 2)
Summary
Training to be a doctor and caring for patients are recognized as being stressful and demanding. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance communication and compassion, and have since been widely adopted as a way of fostering compassion. The continuum of education suggests that medical students need to develop these attributes in conjunction with resilience and maintaining empathy. The benefits of SCRs in fostering this development in medical students is unexplored. Key questions remain as to how medical schools can foster resilience and maintain compassion during medical training with an ever-increasing focus on ‘cure’ and use of technology. In postgraduate medicine in the UK, a number of initiatives have been introduced which aim to promote compassion and empathy in the individual and their institution [6]. By comparison, ‘Compassionate Conversations’ is a small initiative aimed at hospital staff as diverse as porters and chief executives to promote staff engagement and reflection [8]
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