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ARTICLES:
Marc-Antoine Landry, Sylvie Lafrenaye, Marie-Claude Roy, and Claude Cyr
A Randomized, Controlled Trial of Bedside Versus Conference-Room Case Presentation in a Pediatric Intensive Care Unit
Pediatrics 2007; 120: 275-280 [Abstract] [Full text] [PDF]
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[Read P3R] Teaching on ward rounds and daily routine - 2 separate issues ??
Rajesh Phatak   (7 August 2007)

Teaching on ward rounds and daily routine - 2 separate issues ?? 7 August 2007
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Rajesh Phatak,
SpR PICU
Leeds Teaching Hospitals NHS Trust

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Re: Teaching on ward rounds and daily routine - 2 separate issues ??

rajesh.phatak{at}gmail.com Rajesh Phatak

I read the article by Landry et al with great interest. Practices vary considerably on our PICU and parents are not allowed on the "business" ward round early in the morning,primarily to enable patient confidentiality.This allows adequate freedom for residents/fellows to present the cases fluently and also various clinical queries can then be addressed both ways between residents and consultants.I strongly suspect that bedside case presentations without the presence of parents puts the residents well within their comfort zones and this optmizes both teaching and learning and patient care. Subsequently, parents (and patients) have ample opportunity to discuss their childs care with the attending consultant and resident through the day.Communication is then enhanced without any time constraints. The nursing staff provide a supporting and validatory role in both situations,supporting the residents and parents in the 2 seprate occassions respectively. This enhances the functioning of the team. Though the study has it's own limitations,several interesting facts have been highlighted with this study.They have acknowledged the fact that this a small study with small numbers in both groups. It is very heartening to note that overall parent satisfaction was higher.It would be interesting to note responses of patients(if they were old enough to respond appropriately and independently) and compare them with those of their parents.We are often guilty of not including the child in the discussions.We should strive not only to provide accurate information to patients and parents in a language they can grasp,but also encourage residents to formulate management plans based on their experience with the patient. It would perhaps be useful to assess if the seniority of the resident presenting the case or addressing the quereies had any impact on the comfort factor in either bed side or conference situations.

Conflict of Interest:

None declared