It can be challenging for academic hospitalists to balance the increasing clinical demands from hospital systems and resident perceived time constraints with duty hour limitations. We present a series of quick evidence-based educational tips to help hospitalists improve the efficiency and effectiveness of teaching rounds in this evolving landscape.

Scenario:

You are three days into a weeklong stretch of service on a teaching team comprised of one resident, two interns, and three 3rd year medical students. Your list is currently at capacity with 16 patients, which includes 3 new patients who were admitted overnight. One of the new patients has evidence of biliary obstruction, and per handoff from the overnight admitting team GI is considering ERCP. Your resident and interns have already pre-rounded on all 16 of the patients on your list.

Tip: Via text string or team huddle the day before, or earlier on the morning of, identify with your senior resident which patients will be appropriate for bedside rounding as a team, and which patients will have their care plans discussed but can be seen at the bedside by each team member independently.

• Capitalizing on the common perception of increased speed of chart rounding for some patients can help maintain the educational and patient communication benefits of bedside rounding for the other pre-identified patients on your list.
• The criteria for which patients are targeted for bedside rounding can vary and be based on the clinical needs of the patients, as well as both your and your residents' educational objectives.
• Considerations for patients who may be well-suited for bedside rounding can include but are not limited to:
• New patients added to your list from overnight
• Patients with new or progressively increasing acuity
• Patients with interesting pathologies or physical exam findings
• Patients whose care plans for that day will involve new procedures, consults, or diagnostic studies
• In the above scenario, the patient who is being considered for an ERCP offers a great opportunity for bedside rounding as a team because a learner could be observed as they explain the procedure to the patient.

Shaik T, Aggarwal K, Singh B, Sawhney A, Naguluri R, Jain R, Jain R. A comprehensive analysis of different types of clinical rounds in hospital medicine. Proc (Bayl Univ Med Cent). 2023 Dec 20;37(1):135-141.

Brought to you by the Medical Education Workgroup.

Do you have comments or an idea for a future Educator's Corner? Email Lucy at lzshi@ucdavis.edu.