Work rounds are considered a valuable educational facet of residency training. Developing predefined outcome measures for gauging the educational impact of work rounds may be an important step in clarifying their importance and/or optimizing their use. A potential way to assess the educational role of work rounds in a training program may be to link specific outcome measures to the occurrence of daily work rounding sessions. Thus, by changing the frequency of work rounds, their impact on specific outcomes may be determined. To initiate these studies, we investigated a method for increasing work rounding frequency and theorized that increasing the number of residents per ward team may result in an increase in the number of weekly work rounding sessions. These data indicate that adding a second upper-level resident to traditional ward teams results in an increase in the frequency of work rounds.
Methods The effect of the number of residents per team on work rounding frequency was determined by comparing the number work rounds per week between traditional ward teams (one upper-level resident and two interns) and resident-enhanced teams (two upper-level residents and two interns). Traditional ward teams were used exclusively from July 1, 2004, through June 30, 2005 (Trad-pre) and from January 1, 2006, through March 31, 2006 (Trad-post). Resident-enhanced teams (ResEn) were used and studied from July 1, 2005, through November 30, 2005. The frequency of work rounds was determined for the Trad-pre period by surveying residents in the program in June 2005. Work rounding frequency for ResEn and Trad-post was assessed by surveying the members of all ward teams at the conclusion of each monthly rotation. The mean number of work rounding sessions per week for each survey period was compared using one-way ANOVA.
Results A total of 74 surveys were received as follows: Trad-pre = 21, ResEn = 40 (July-November), and Trad-post = 14. The number of work rounding sessions per week for Trad-pre, ResEn, and Trad-post were 2.9 ± 0.2 (mean ± SEM), 3.9 ± 0.2, and 2.8 ± 0.3, respectively (p < .002 when ResEn was compared with the other groups). These data indicate that work rounding frequency is significantly increased by ResEn ward teams and suggests that an additional upper-level resident on traditional ward teams may help increase the number of weekly work rounding sessions. Additional outcome measures were not assessed in this study.
Conclusion Increasing upper-level resident manpower on inpatient ward teams may be a way to increase the frequency of work rounds. Correlating this approach to appropriate outcome measures may further define its educational value.
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