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Nephrology Fellows? and Program Directors? Perceptions of Hospital Rounds in the United States
Journal article   Open access

Nephrology Fellows? and Program Directors? Perceptions of Hospital Rounds in the United States

Suzanne M. Boyle, Keshab Subedi, Kurtis A. Pivert, Meera Nair Harhay, Jaime Baynes-Fields, Jesse Goldman and Karen M. Warburton
Clinical journal of the American Society of Nephrology, v 15(4), pp 474-483
07 Apr 2020
DOI: https://doi.org/10.2215/CJN.10190819
PMID: 32184295
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.2215/cjn.10190819View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Science & Technology Urology & Nephrology
Background and objectivesHospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.Design, setting, participants, & measurementsWe conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology?s 2019 Nephrology Training Program Directors? Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows? clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.ResultsFellow and program director response rates were 73% (n=621) and 70% (n=55). Most fellows (74%) report a patient census of >15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows? clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).ConclusionsHospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_03_17_CJN.10190819.mp3

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6 citations in Web of Science
5 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Urology & Nephrology
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