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Background And Objectives: The Accreditation Council for Graduate Medical Education requires that residents demonstrate increasing autonomy during their training. Although residents report a better educational environment with hospitalists present during family-centered rounds (FCRs), there is a concern that attending presence may reduce resident autonomy. We aim to determine the effect of FCRs without an attending during rounds on senior residents' sense of autonomy.
Methods: We conducted a multicenter, retrospective, preintervention-postintervention study at 5 children's hospitals to evaluate the effect of rounding without an attending on senior residents' self-efficacy, using a questionnaire developed by using Bandura's principles of self-efficacy and Accreditation Council for Graduate Medical Education milestones. Questions addressed skills of diagnosis and/or management, communication, teaching, and team management. We compared preintervention and postintervention results using paired tests and Wilcoxon rank tests. One-way analysis of variance tests were used to compare means among >2 groups.
Results: 116 (82% response rate) of 142 eligible senior residents completed the questionnaire, which yielded a high reliability (α = 0.80) with a 1-factor score. The average composite score of self-efficacy significantly improved after intervention compared with the preintervention score (66.71 ± 6.95 vs 60.91 ± 6.82; < .001). Additional analyses revealed meaningful improvement of each individual item postintervention. The highest gain was reported in directing bedside teaching (71.8% vs 42.5%; < .001) and answering learner questions on rounds (70.7% vs 47.0%; < .001).
Conclusions: Conducting FCRs without an attending increases resident reported self-efficacy regarding core elements of patient care and team leadership. In future studies, researchers should examine the impact of rounding without the attending on other stakeholders, such as students, interns, patients and/or families.
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http://dx.doi.org/10.1542/hpeds.2021-005971 | DOI Listing |
BMC Nurs
December 2024
College of NursingᆞResearch Institute of Nursing Science, Pusan National University, 49 Busandaehak-Ro, Mulgeum-Eup, Yangsan-Si, 50612, Gyeongsangnam-Do, Korea.
Background: Integrating family members into the care of hospitalized end-of-life patients enhances patient-family-centered care and significantly influences the experiences of patients and their families. This study used the integrative review methodology to assess the scope and effectiveness of interventions designed to facilitate family involvement in end-of-life care. It identified gaps and consolidated existing knowledge to improve nursing practices.
View Article and Find Full Text PDFCommunity Ment Health J
December 2024
McLean Hospital, Belmont, MA, USA.
This study examined the impact of Patient-Centered Communication (PCC), Open Dialogue-inspired changes to rounding practices and culture, on patient perceptions of care on an inpatient psychotic disorders unit. A retrospective cohort analysis was conducted based on medical records, restraint and seclusion records, and hospital Perceptions of Care (PoC) surveys. The analysis compared data from 6-month periods before and after implementation of PCC to quantify whether the implementation of PCC was associated with more positive care ratings.
View Article and Find Full Text PDFInt J Health Care Qual Assur
December 2024
Cleveland Clinic, Cleveland, Ohio, USA.
Purpose: Family-centered rounds (FCR) are a multidisciplinary process in which patients and/or family members are present and actively participate in medical rounds. While research has shown that FCR may enhance collaborative information exchange and reduce family anxiety, the impact of the information exchange modality on the experience has been largely unexplored. Medical rounds are typically assumed to be carried out in person at the bedside.
View Article and Find Full Text PDFDisabil Rehabil
December 2024
Department of Physical Therapy, Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, Canada.
Purpose: To seek agreement on evidence-based, family-centered, clinical considerations for Ankle Foot Orthosis (AFO) prescription and monitoring for young, ambulatory children with cerebral palsy.
Materials And Methods: An online Delphi survey focusing on parent, clinician, and researcher perspectives on specific processes and outcomes concerning AFO prescription and monitoring practices was conducted over two rounds. Participants rated each survey item as critical, important but not critical, or less important.
Belitung Nurs J
November 2024
Institute of Biomedical Sciences, Tokushima University, Graduate School, Tokushima, Japan.
Background: Stroke is the leading cause of disability and the second leading cause of death worldwide. In the Philippines, there is a lack of a unified system for the care of community-dwelling patients with stroke. Furthermore, rehabilitation facilities are underutilized, and human resources and financial support policies are lacking.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!