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

Abstract

Introduction: The use of clinical rounds, as an integral part of clinical teaching to help medical students acquire essential skills of practicing medicine, is critically important. An understanding of medical teachers' perceptions concerning the challenges of clinical rounds can help identify the key areas of focus to better foster professional development of medical students. This study explored the opinions of medical teachers of Kerman University of Medical Sciences about the challenges embedded in clinical rounds. There is a paucity of studies regarding the topic under investigation in our context. Methods: This qualitative study was conducted using a conventional content analysis method. We held a focus group discussion with eight skilled bedside teachers, chosen using purposive sampling, from Kerman University of Medical Sciences in February 2018. The focus group lasted for approximately 2 hours. The session was audio-taped. We analyzed data by considering the verbatim transcribed document of the audio-recorded discussions using conventional content analysis method for theme development. Informed consent was obtained from the participants. Results: Medical teachers described many primary challenges to clinical rounds. Some of them were multiple students on rounding practices, time constraints, priority of research and patient care to teaching, and lack of participation and enthusiasm. We categorized these 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 mitigate barriers such as having fewer students on the rounds, addressing time constraints through planning and flexibility, and the provision of medical education award. Conclusion: Clinical round practices are valuable but replete with a spectrum of problems. Many challenges affect the quality of teaching in clinical rounds that should be taken into account by bedside teachers in order to improve the quality of rounding practices. The identified challenges can be used in redressing bedside teaching to have more efficient rounding practices.