Council on Medical Student Education in Pediatrics


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Improving hand-offs and developing empathy with one intervention!
Developing non-technical ward-round skills.
Harvey R et al. The Clinical Teacher 2015; 12: 336-340.

Reviewed by Janet Meller - THIS IS HER 10TH REVIEW!!!

What was the study question?
Can a model of non-technical skills utilized during ward rounds be developed to facilitate transition from student to physician?

How was the study done?
A 30 minute simulation of acute hand-off rounds was developed. Tasks expected included documentation and clinical plan. Non technical skills to be assessed were cognitive, social, and personal resource skills which are felt to contribute to safe and efficient care. The simulation was run with two groups of students participating as the patients and the physicians. Faculty acted as staff nurse, charge nurse and attending physician. The simulation lasted 20 minutes and then a 30 minute debrief to discuss challenges and identify solutions. The simulation was repeated with the groups switching roles followed by an additional debrief to discuss effectiveness of previously discussed solutions. Students then completed a written feedback tool to highlight the key learning points they identified. 217 fourth year students participated. The responses were collated and analyzed.

What were the results?
97% of the students agreed that the simulation improved insight into the challenges of ward rounds and the ability to work as a team. Task prioritisation and task overload were the most frequently identified challenges. An unanticipated category of empathy was identified as a result of students acting as patients.

What are the implications?
Simulated ward round hand-offs improved efficiency and provided insight into the accompanying challenges for students. This improved performance may result in enhanced patient safety as trainees take these lessons forward. The area of enhanced empathy provides an opportunity for further study.

Editor’s note: That this study enhanced empathy in students (one said ‘Don’t forget the patient during ward rounds’) was an unexpected, and positive, outcome. Perhaps there are other ways we can teach clinical skills and empathy at the same time (SLB).

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