How can we better prepare new doctors for the tasks and challenges of ward rounds? An observational study of junior doctors? experiences

Cheryl Louise Bell* (Corresponding Author), Julia Allan, Sarah Ross, Daniel Powell, Derek Johnston

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose
Ward rounds play a crucial role in the delivery of patient care in inpatient settings, but involve a complex mix of tasks, skills and challenges for junior doctors to negotiate. This study informs the development of high-quality training by identifying the activities that junior doctors perform, and those associated with stress during real-life ward rounds.

Materials and methods
All activities performed by FY1 doctors (n = 60) over 2 ward rounds were coded in real-time by a trained observer using the work observation method by activity timing (WOMBAT). Doctors’ heart rate was continuously recorded and non-metabolic peaks in heart rate used as a physiological indicator of stress.

Results
During ward rounds, FY1 doctors commonly engaged in indirect patient care, professional communication, documentation and observation. Very little time was spent on direct patient care (6%) or explicit supervision/education (0.01%). Heart rate data indicated that stress was highest during administrative tasks while interacting directly with patients while stepping out of rounds to complete personal tasks, when answering bleeps and while multi-tasking.

Conclusions
Training that specifically covers the activities involved, skills required, and challenges inherent in real-life ward rounds may better prepare FY doctors for this complex area of practice.
Original languageEnglish
Number of pages8
JournalMedical Teacher
Early online date2 Jul 2021
DOIs
Publication statusE-pub ahead of print - 2 Jul 2021

Keywords

  • Ward rounds
  • junior doctors stress
  • heart rate

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