I remember as a third year student feeling pretty disappointed when I discovered that some attending physicians chose to hold table rounds, or hallway rounds in a very public setting. These “rounds” involved either sitting at a table and discussing diagnoses and physical exam findings or standing in the hospital hallways reporting labs and discharge plans. On my current rotation, however, my attending, Dr. Jonathan Miller, announced that he would be sticking to his usual style of “bedside” rounding.
Now, I have rounded at the bedside before, but I have never given my formal oral presentation in medical terminology or discussed my differential diagnoses and reasoning before my patients and their families. I was instantly sold on the idea because I loved the fact that I would get to see every single patient on our service that morning.
In addition, this type of rounding enabled the family to feel wholly involved in the medical planning. It provided family members with the opportunity to add details that may have been missed during history taking or to clarify facts that were unclear. It forced me to practice the use of medical terminology and translate it into a language that parents and young patients were able to understand. Parents readily joined in the conversation when discussing our future plans for treatment and discharge, which ensured that we all agreed on the next few steps.
Many of the residents were wary about time management and the duration of time spent in each patient’s room when using this style of rounding. I admit that our rounds finished close to our afternoon conference on some days of the week. Yet, as we continued to follow this style, we became more efficient. There were several days that we concluded rounds with an hour between our journey from one patient’s bedside to another and our afternoon conference.
As a student, I felt as though I learned more information collectively from this week than I had on prior six week long rotations as a third year student. Discussions with family members and explanations served as built-in teaching time for the students. Having the chance to see each patient sharpened my physical diagnosis skills. Listening to family questions and concerns prompted me to anticipate common obstacles and fears associated with specific diagnoses.
Overall, I loved this style of rounding from the very beginning of the week to the very end. I cannot recommend it strongly enough to attending physicians in an academic, or any setting, in which they want to enhance patient care and simultaneously expand the knowledge of medical students and all others involved.
