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BEIGZADEH, AMIN, BAHAADINBEIGY, KAMBIZ, ADIBI, PEYMAN, YAMANI, NIKOO. (1398). Identifying the challenges to good clinical rounds: A focus-group study of medical teachers. سامانه مدیریت نشریات علمی, 7(2), 62-73. doi: 10.30476/jamp.2019.44710
AMIN BEIGZADEH; KAMBIZ BAHAADINBEIGY; PEYMAN ADIBI; NIKOO YAMANI. "Identifying the challenges to good clinical rounds: A focus-group study of medical teachers". سامانه مدیریت نشریات علمی, 7, 2, 1398, 62-73. doi: 10.30476/jamp.2019.44710
BEIGZADEH, AMIN, BAHAADINBEIGY, KAMBIZ, ADIBI, PEYMAN, YAMANI, NIKOO. (1398). 'Identifying the challenges to good clinical rounds: A focus-group study of medical teachers', سامانه مدیریت نشریات علمی, 7(2), pp. 62-73. doi: 10.30476/jamp.2019.44710
BEIGZADEH, AMIN, BAHAADINBEIGY, KAMBIZ, ADIBI, PEYMAN, YAMANI, NIKOO. Identifying the challenges to good clinical rounds: A focus-group study of medical teachers. سامانه مدیریت نشریات علمی, 1398; 7(2): 62-73. doi: 10.30476/jamp.2019.44710

Identifying the challenges to good clinical rounds: A focus-group study of medical teachers

Journal of Advances in Medical Education & Professionalism
مقاله 3، دوره 7، شماره 2، تیر 2019، صفحه 62-73    اصل مقاله (543.16 K)
شناسه دیجیتال (DOI): 10.30476/jamp.2019.44710
نویسندگان
AMIN BEIGZADEH1؛ KAMBIZ BAHAADINBEIGY2؛ PEYMAN ADIBI3؛ NIKOO YAMANI* 1
1Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
3Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده
Introduction: The use of clinical rounds, as an integral part ofclinical teaching to help medical students acquire essential skillsof practicing medicine, is critically important. An understandingof medical teachers’ perceptions concerning the challenges ofclinical rounds can help identify the key areas of focus to betterfoster professional development of medical students. This studyexplored the opinions of medical teachers of Kerman Universityof Medical Sciences about the challenges embedded in clinicalrounds. There is a paucity of studies regarding the topic underinvestigation in our context. 
Methods: This qualitative study was conducted using aconventional content analysis method. We held a focus groupdiscussion with eight skilled bedside teachers, chosen usingpurposive sampling, from Kerman University of Medical Sciencesin February 2018. The focus group lasted for approximately2 hours. The session was audio-taped. We analyzed data byconsidering the verbatim transcribed document of the audiorecordeddiscussions using conventional content analysis methodfor theme development. Informed consent was obtained from theparticipants.
Results: Medical teachers described many primary challenges toclinical rounds. Some of them were multiple students on roundingpractices, time constraints, priority of research and patient care toteaching, and lack of participation and enthusiasm. We categorizedthese varied challenges into 5 specific areas related to (1) system;(2) teachers; (3) learners; (4) patients; and (5) evaluation issues.Focus group participants expressed some suggestions to mitigatebarriers such as having fewer students on the rounds, addressingtime constraints through planning and flexibility, and the provisionof medical education award.
Conclusion: Clinical round practices are valuable but repletewith a spectrum of problems. Many challenges affect the qualityof teaching in clinical rounds that should be taken into accountby bedside teachers in order to improve the quality of roundingpractices. The identified challenges can be used in redressingbedside teaching to have more efficient rounding practices.
کلیدواژه‌ها
Clinical؛ Focus group؛ Medical teachers
مراجع
  1. Kroenke K, Omori D, Landry F, Lucey C. Bedside teaching. Southern Med J 1997; 90(11): 1069-74.
  2. Arapakis GI. Clinical findings and diagnostic. 2006; 4th edn. Pascalides Press, Athens.
  3. Osler W. On the need of a radical reform in our teaching methods: Senior students. Med News 1903; 82:49-53.
  4. Tariq M, Motiwala A, Ali U, Riaz M, Awan S, Akhter J. The learners’ perspective on internal medicine ward rounds: a cross-sectional study. BMC Med Educ 2010; 10:53.
  5. Dewhurst G. Time for change: teaching and learning on busy post-take ward rounds. Clin Med 2010; 10(3): 231-4.
  6. Kianmehr N, Mofidi M, Yazdanpanah R, Ahmadi A.M. Medical student and patient perspectives on bedside teaching. Saudi Medical Journal 2010; 31 (5): 565-8.
  7. Anbari Z, Ramezani M. The obstacles of clinical education and strategies for the improvement of quality of education at Arak University of Medical Sciences in 2008. AMUJ. 2010; 13 (2): 110-118. [In Persian]
  8. Karimi Monaghi H, Derakhshan A, Khajedalouei M, Dashti Rahmat abadi M, Binaghi T. Lived clinical learning experiences of medical students: A qualitative approach. Iranian Journal of Medical Education. 2012; 11 (6): 635-647. [In Persian]
  9. Adibi P, Alizadeh R. The Effects of Clinical Rounds on Patients in Internal Wards of Hospitals Affiliated to Isfahan University of Medical Sciences: The Viewpoints of Clinical Care Team Iranian Journal of Medical Education. 2007; 7(1): 15-21. [In Persian]
  10. Adibi P, Anjevian M. The clinical rounds on patients' bedside in internal ward from patients' viewpoints. Iranian Journal of Medical Education. 2006; 6 (1): 15-21. [In Persian]
  11. Arabshahi KS, Haghani F, Bigdeli S, Omid A, Adibi P. Challenges of the ward round teaching based on the experiences of medical clinical teachers. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences. 2015; 20(3): 273-280.
  12. Gandomkar R, Salsali M, Mirzazadeh A. Factors influencing medical education in clinical environment: Experiences of clinical faculty members. Iranian Journal of Medical Education. 2011; 11 (3): 279-290. [In Persian]
  13. Parsell G, Bligh J. Recent perspectives on clinical teaching. Medical Education. 2001; 35(4): 409-14.
  14. Merton RK, Kendall PL. The focused interview. American journal of Sociology. 1946: 51(6): 541-57.
  15. Stalmeijer ReE, McNaughton N, Van Mook WNKA. Using focus groups in medical education research: AMEE Guide No. 91. Medical teacher. 2014; 36(11): 923-39. doi: 10.3109/0142159X.2014.917165
  16. Barbour RS. Doing focus groups. London: SAGE Publications Ltd. 2007.
  17. Kitzinger J. Qualitative research: introducing focus groups. BMJ. 1995; 311:299-302.
  18. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004: 24(2): 105-12.
  19. Baker. Depression and suicide in adolescents with epilepsy. Neurology 2006; 66: S5–S12 (Suppl. 3).
  20. McCagh J, Fisk JE, Baker GA. Epilepsy, psychosocial and cognitive functioning. Epilepsy Res 2009: 86: 1–14.
  21. Strauss A, Corbin J. Basics of qualitative research grounded theory procedures and technique. London: SAGE Publications Ltd. 1998.
  22. Jalalvandi F, Yeganeh N, Shahsavari S, Ghorbani S, Moradi O, Ahmadi S, Behzadi AR. Evaluation of medical students’ views on the current state of clinical education. J Clin Res Paramed Sci 2014; 2(4): 260-266. [In Persian]
  23. Ramani S, Orlander J, Strunin L, Barber T. Whither Bedside Teaching? A Focus-group Study of Clinical Teachers. Academic Medicine 2003; 78 (4): 384-390.
  24. Gonzalo J, Heist BS, Duffy BL, Dyrbye L, Fagan MJ, Ferenchick G, et al. Identifying and Overcoming the Barriers to Bedside Rounds: A Multicenter Qualitative Study. Academic Medicine 2014; 89 (2): 326-334.
  25. Force J, Thomas I, Buckley F. Reviving post-take surgical ward round teaching. The clinical teacher. 2014; 11 (2): 109-115.
  26. Salari A, Moaddab F, Rouhi Balasi L, Dadgaran I, Nourisaeed A, Pourali H, et al. Medical Interns’ Satisfaction of Clinical Education's Quality in Rasht Hospitals. Educ Res Med Sci 2016; 5(2): 97-102. [In Persian]
  27. Williams K, Ramani S, Fraser B, Orlander J. Improving Bedside Teaching: Findings from a Focus Group Study of Learners. Academic Medicine 2008; 83 (3): 257-264.
  28. Shams B, Jamshidian S, Changiz T. Educational challenges in ambulatory pediatrics teaching programs based on the experiences of Interns and attends: a qualititaive study. Strides Dev Med Educ. 2011; 7 (2): 81-91. [In Persian]
  29. Ahmady S, Hosseini M A, Homam S M, Farajpour A, Ghitaghi M, Hosseini-Abardeh M. Challenges of Medical Education at Islamic Azad University, Iran, from Faculty Perspectives: A Qualitative Content Analysis. Strides Dev Med Educ. 2016; 13 (2): 114-132. [In Persian]
  30. Claridge A. What is the educational value of ward rounds? A learner and teacher perspective. Clin Med 2011; 11(6): 558-62.
  31. Nematbakhsh M. Research on health system reform plan. Letter to editor. Iranian Journal of Medical Education. 2015; 15: 64-66.
  32. Esteghamati AR, Baradaran HR, Monajemi AR, Khankeh HR, Geranmayeh M. Core components of clinical education: a qualitative study with attending physicians and their residents. J Adv Med Educ Prof. 2016; 4 (2): 64-71.
  33. Jaye C, Egan T, Smith-Han K, Thompson-Fawcett M. Teaching and learning in the hospital ward. N Z Med J. 2009; 9; 122 (1304):13-22.
  34. Nair BR, Coughlan JL, Hensley MJ. Impediments to bed-side teaching. Med Educ. 1998; 32(2): 159-162.
  35. Al-Swailmi FK, Khan IA, Mehmood Y, Al-Enazi SA, Alrowaili M, Al-Enazi MM. Students’ perspective of bedside teaching: A qualitative study. Pakistan Journal of Medical Sciences. 2016; 32 (2): 351-355. doi:10.12669/pjms.322.9194.
  36. Shehab A. Clinical Teachers’ Opinions about Bedside-based Clinical Teaching.Sultan Qaboos University Medical Journal. 2013; 13(1): 121-126.
  37. Dybowski C, Harendza S. Bedside Teaching: general and discipline-specific teacher characteristics, criteria for patient selection and difficulties. GMS Z Med Ausbild. 2013; 30 (2): 1-17 doi:10.3205/zma000866.
  38. Ways M, Kroenke K, Umali J, Buchwald D. House-staff attitudes about work rounds. Acad Med 1996; 71:2.
  39. Doherty I, McKimm J. E-learning in medical teaching. Br J Hosp Med (Lond) 2010; 71(1): 44-7.
  40. Nasri K, Kahbazy M, Noroozy A, Nasri S. The medical education problems and possible solutions in stagers and intern's viewpoints of Arak University of Medical Sciences, 2006-07. AMUJ 2010; 12 (4): 111-121. [In Persian]
  41. Mosalanejad L, Hojjat M, Badeyepeyma Z. A Comprehensive Evaluation of the Quality and Barriers of Bedside Teaching from Professors' Point of View. International Journal of Nursing Education; New Delhi 2013; 5 (2): 233-238.
  42. Ziaee V, Ahmadinejad Z, Morravedji AR. An Evaluation on Medical Students’ Satisfaction with Clinical Education and its Effective Factors, Medical Education Online. 2004; 9 (1): 1-8.
  43. Prado H, Falbo G, Falbo A, Figueiroa J. Active learning on the ward round: outcomes from a comparative trial with traditional methods. Med Educ 2011; 45: 273-9.
  44. Abdool MA, Bradley D. Twelve tips to improve medical teaching rounds. Med Teach 2013; 35: 895-9.
  45. Laskaratos FM, Wallace D, Gkotsi D, Burns A, Epstein O. The educational value of ward rounds for junior trainees. Med Educ Online. 2015; 20: 27559.
  46. Castiglioni Analia, Shewchuk RM, Willett L, Heudebert GR, Centor RM. A Pilot Study Using Nominal Group Technique to Assess Residents’ Perceptions of Successful Attending Rounds. J Gen Intern Med. 2008; 23 (7): 1060-5. doi: 10.1007/s11606-008-0668-z.
  47. Qureshi N, Swamy N. Postgraduate trainees’ assessment of the educational value of ward rounds in obstetrics and gynaecology.J Obstet Gynaecol 2008; 28(7): 671-5.
  48. Ala M, Khashayar P, Baradaran HR, Larijani B, Aghaee Mybodi HR. Factors affecting the quality of grand round from the perspectives of stagers, interns, residents and fellows. ijdld 2013, 12(2): 160-166. [In Persian]
  49. Siabani S, Moradi MR, Siabani H, Rezaei M, Siabani S, Amolaei K, Ebrahim Karimi E. Students’ view points on the educational problems in medical school of Kermanshah University of Medcial Sciences (2007). J Kermansha Unive Med Sci 2009; 13 (2): 162-171. [In Persian]
  50. Roy B, Castiglioni A, Kraemer RR, Salanitro AH, Willett LL, Shewchuk RM, et al. Using cognitive mapping to define key domains for successful attending rounds. J Gen Intern Med 2011; 27: 1492-8.
  51. Crawshaw A. Team teach: A novel approach to ward round teaching. Med Educ 2010; 44:489-526.
  52. Irby MD, Wilkerson L. Teaching when time is limited. BMJ 2008; 2336:384.
  53. Blasco GP, Moreto G. Teaching Empathy through Movies: Reaching Learners’ Affective Domain in Medical Education. Journal of Education and Learning 2012; 1:1: 22-34.
  54. Praveen L. Indraratna, Louise C. Greenup, and Timothy X. Yang, “Bedside Teaching in Australian Clinical Schools: A National Study,” Journal of Biomedical Education, vol. 2013, Article ID 948651, 5 pages, 2013. doi:10.1155/2013/948651
  55. Celenza A, Rogers IR. Qualitative evaluation of a formal bedside clinical teaching programme in an emergency department. Emerg Med J. 2006; 23 (10): 769-73.
  56. Zahedi M, Amirmaleki Tabrizi H. Medical education effectiveness from the viewpoints of medical students of Tehran University of Medical Sciences. Iranian Journal of Medical Education. 2008; 7 (2): 289-298. [In Persian]
  57. Rezaee R, Ebrahimi S. Clinical Learning Environment at Shiraz Medical School. Acta Medica Iranica, 2013; 51 (1): 62-65.
  58. Azemian A, Motamed N, Yousefi MR. Barriers and Facilitating Factors in Learning of Effective Clinical Teaching in Bushehr University of Medical Sciences: Clinical Students, Point of View. 2015; 6(1): 8-17. [In Persian]
  59. Yoder-Wise P S (2004) Leading and managing in nursing. 3th edition. St. Louis, Mo., Mosby/Elsevier.
  60. Ayanian JZ, Cleary PD, Weissman JS, Epstein AM. The effect of patients' preferences on racial differences in access to renal transplantation. N Engl J Med. 1999;341:1661–9.
  61. Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998; 47:213–20.
  62. Keating NL, Green DC, Kao AC, Gazmararian JA, Wu VY, Cleary PD. How are patients specific ambulatory care experiences related to trust, satisfaction, and considering changing physicians. J Gen Intern Med. 2002;17:29–39.
  63. Thom DH, Bloch DA, Segal ES. An intervention to increase patients' trust in their physicians: Stanford Trust Study Group. Acad Med. 1999;74:195–8.
  64. Kao AC, Green DC, Zaslavsky AM, Koplan JP, Cleary PD. The relationship between method of physician payment and patient trust. JAMA. 1998;280:1708–14.
  65. Kao AC, Green DC, Davis NA, Koplan JP, Cleary PD. Patients' trust in their physicians: effects of choice, continuity, and payment method. J Gen Intern Med. 1998;13:681–6.
  66. Anderson LA, Dedrick RF. Development of the trust in physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67(part 2):1091–100.
  67. Schiekirka S, Feufel MA, Herrmann-Lingen C, Raupach T. Evaluation in medical education: A topical review of target parameters, data collection tools and confounding factors. GMS Ger Med Sci. 2015;13:Doc15. DOI: 10.3205/000219, URN: urn:nbn:de:0183-0002197
  68. Husain M, Khan S. Students’ feedback: An effective tool in teachers’ evaluation system. International Journal of Applied and Basic Medical Research. 2016;6(3):178-181. doi:10.4103/2229-516X.186969.
  69. BASTANI, Peivand et al. Teachers Evaluation Methods in Medical Education: Round Views of Faculty Members and Educational Experts. Galen Medical Journal, [S.l.], v. 6, n. 3, p. 233-239, sep. 2017. ISSN 2322-2379.
  70. Farrell SE. Evaluation of student performance: clinical and professional performance. Acad Emerg Med 2005; 12 (4): 302-10.
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