Abstract:
OBJECTIVES:Teaching at the bedside during attending rounds is considered to be fundamental to medical education. We conducted an ethnographic case study to investigate such teaching in general paediatrics as a social phenomenon and to explore change over time in both the meaning of rounds and the context in which rounds take place. METHODS:We conducted a case study from January to August 2006 on a 22-bed general paediatric unit in an urban children's hospital and focused our observation on interns, senior residents and attending physicians. We observed the medical team during its normal activities on the study unit and conducted semi-structured interviews with a sample of attendings, interns and senior residents. We compiled a list of codes that emerged from patterns in the data and constructed a rich description of rounds according to the principles of inductive analysis. RESULTS:Four themes emerged from the data: (i) attending rounds are a pervasive and routine part of clinical education; (ii) interns, senior residents and attending physicians hold assumptions about what should happen on rounds; (iii) tension exists between interns', senior residents' and attending physicians' assumptions about bedside teaching during rounds and the reality imposed by contextual factors, and (iv) bedside teaching during rounds is impacted, but not prohibited, by contextual factors. CONCLUSIONS:Our case study provides evidence that bedside teaching during rounds is a pedagogical ideal entrenched in medical education. Participants readily acknowledged teaching at the bedside during rounds as something they perceived should happen, although, in actuality, it was infrequently achieved. This study revealed a telling inconsistency in language and behaviour: 'bedside rounds' was embedded in the participants' ordinary language, but the activity was not necessarily part of their ordinary behaviour. We propose that the practice of bedside teaching is best explained as a ritual. Considering bedside teaching as a ritual helps to explain why rounds are sacrosanct and helps to develop more appropriate expectations for rounds.
journal_name
Med Educjournal_title
Medical educationauthors
Balmer DF,Master CL,Richards BF,Serwint JR,Giardino APdoi
10.1111/j.1365-2923.2010.03767.xsubject
Has Abstractpub_date
2010-11-01 00:00:00pages
1105-16issue
11eissn
0308-0110issn
1365-2923journal_volume
44pub_type
杂志文章abstract::This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving ...
journal_title:Medical education
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journal_title:Medical education
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journal_title:Medical education
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journal_title:Medical education
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journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1986.tb01388.x
更新日期:1986-11-01 00:00:00
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journal_title:Medical education
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journal_title:Medical education
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journal_title:Medical education
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doi:10.1046/j.1365-2923.2000.00571.x
更新日期:2000-06-01 00:00:00
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journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1983.tb01124.x
更新日期:1983-11-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:1999-08-01 00:00:00
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journal_title:Medical education
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journal_title:Medical education
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更新日期:1981-03-01 00:00:00
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更新日期:1989-01-01 00:00:00
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