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
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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 |