Strategies for teaching in clinical rounds: A systematic review of the literature

Abstract

Background: Strategies for teaching in clinical rounds are dispersed. There is a need to comprehensively collate bedside strategies to enhance teaching and learning and make clinical rounds more effective. Materials and Methods: A systematic review of English articles using Web of Science, PubMed, Embase, Scopus, and Cochrane library was conducted. Relevant keywords for teaching rounds/medical teachers/medical students/strategies and their synonyms were used accordingly. Additional studies were identified by searching reference lists of retrieved articles. All searches were conducted within a 10-day period from May 25, 2017, to June 3, 2017. In this systematic review, studies with any design on the subject of strategies for clinical rounds from clinical teachers' and medical students' perspectives were identified. Our search strategy yielded 524 articles. After removing duplicates, 337 articles remained. Based on the title and abstract review, 37 articles were obtained for further review and finally 18 entered the study. Data were extracted from the included studies. Two authors independently screened and scored the studies. We used inductive content analysis, and categories of strategies were derived from the data. Results: Content analysis yielded identification of strategies for clinical rounds in nine categories named: system issues, advance planning, a preround huddle, patient issues, teachable moments, teacher issues, student issues, atmosphere issues, and a postround huddle. These were classified as "before rounds," "during rounds," and "after rounds" activities. Quality assessment scores for the research studies ranged from 5 to 14 (possible range, 1-16). Fourteen (77.8) studies received quality scores at or above 10, and 4 (22.2) studies received quality scores below 10. Conclusion: Due to the importance of clinical rounds in students' learning, medical teachers should divide their teaching session into activities before, during, and after rounds. These strategies on rounding practices can improve teaching and learning.