• Jed D Gonzalo, Brian S Heist, Briar L Duffy, Liselotte Dyrbye, Mark J Fagan, Gary Ferenchick, Heather Harrell, Paul A Hemmer, Walter N Kernan, Jennifer R Kogan, Colleen Rafferty, Raymond Wong, and D Michael Elnicki.
• Pennsylvania State University College of Medicine, Hershey, PA, USA. jgonzalo@hmc.psu.edu
• J Gen Intern Med. 2013 Mar 1; 28 (3): 412420412-20.

BackgroundMedical educators believe bedside rounds are effective for the delivery of patient-centered care, and are necessary in helping trainees acquire competence in clinical care. Although recommendations for bedside rounds have been reported, a recent, systematic assessment of strategies used by current-day bedside teachers was needed to advance knowledge of this teaching method.ObjectiveTo identify and understand bedside teachers' 1) preparatory steps, 2) patient selection, and 3) role allocation during the process of bedside rounds.DesignA qualitative inductive thematic analysis using transcripts from audio-recorded, semi-structured telephone interviews.ParticipantsInternal medicine physicians (n = 34) who perform bedside rounds from ten academic US institutions (2010-2011).ApproachA purposive sampling strategy was utilized to identify physicians who were active inpatient attending physicians and met specific inclusion criteria for "bedside rounds." A total of 34 interviews were completed, and each was recorded and transcribed verbatim. A thematic analysis extracted key themes pertaining to the three objectives.Key ResultsMost respondents (51 %) were associate or full professors, with an average of 14 years of academic experience. Attending physicians prepared using trainee-specific, patient-specific and disease-specific information, while also mentally preparing for bedside rounds. They sought trainee buy-in and learning objectives, reviewed expectations and methods to ensure patient comfort, and provided early guidance with bedside encounters. Patients were selected if they required immediate care, were new to the service, or had a high educational value, while patients were deferred if unavailable, unwilling, or unable to communicate. The team members' roles during bedside rounds varied, with trainees being given graduated autonomy with increased experience.ConclusionsBedside teachers' methods for preparation, patient selection, and role allocation during bedside rounds enhance trainees' education within the workplace. Strategies used by experienced bedside teachers can be used for faculty development efforts aimed at promoting this activity.

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