• Christoph Becker, Martina Gamp, Philipp Schuetz, Katharina Beck, Alessia Vincent, Seraina Hochstrasser, Kerstin Metzger, Madlaina Widmer, Emanuel Thommen, Beat Mueller, Christoph A Fux, Jörg D Leuppi, Rainer Schaefert, Wolf Langewitz, Marten Trendelenburg, Tobias Breidthardt, Jens Eckstein, Michael Osthoff, Stefano Bassetti, Sabina Hunziker, and BEDSIDE-OUTSIDE Study Group.
• University Hospital Basel, Basel, Switzerland (C.B., M.G., K.B., A.V., S.H., K.M., M.W., E.T.).
• Ann. Intern. Med. 2021 Sep 1; 174 (9): 1282-1292.

BackgroundAlthough bedside case presentation contributes to patient-centered care through active patient participation in medical discussions, the complexity of medical information and jargon-induced confusion may cause misunderstandings and patient discomfort.ObjectiveTo compare bedside versus outside the room patient case presentation regarding patients' knowledge about their medical care.DesignRandomized, controlled, parallel-group trial. (ClinicalTrials.gov: NCT03210987).Setting3 Swiss teaching hospitals.PatientsAdult medical patients who were hospitalized.InterventionPatients were randomly assigned to bedside or outside the room case presentation.MeasurementsThe primary endpoint was patients' average knowledge of 3 dimensions of their medical care (each rated on a visual analogue scale from 0 to 100): understanding their disease, the therapeutic approach being used, and further plans for care.ResultsCompared with patients in the outside the room group (n = 443), those in the bedside presentation group (n = 476) reported similar knowledge about their medical care (mean, 79.5 points [SD, 21.6] vs. 79.4 points [SD, 19.8]; adjusted difference, 0.09 points [95% CI, -2.58 to 2.76 points]; P = 0.95). Also, an objective rating of patient knowledge by the study team was similar for the 2 groups, but the bedside presentation group had higher ratings of confusion about medical jargon and uncertainty caused by team discussions. Bedside ward rounds were more efficient (mean, 11.89 minutes per patient [SD, 4.92] vs. 14.14 minutes per patient [SD, 5.65]; adjusted difference, -2.31 minutes [CI, -2.98 to -1.63 minutes]; P < 0.001).LimitationOnly Swiss hospitals and medical patients were included.ConclusionCompared with outside the room case presentation, bedside case presentation was shorter and resulted in similar patient knowledge, but sensitive topics were more often avoided and patient confusion was higher. Physicians presenting at the bedside need to be skilled in the use of medical language to avoid confusion and misunderstandings.Primary Funding SourceSwiss National Foundation (10531C_ 182422).

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