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16594

Family Centered Rounds: Pediatric Residents' Perspective

Sunday, October 21, 2012
Room 281-282 (Morial Convention Center)
Dorothy Chu, MD1, Anna Petrova, MD, PhD, MPH2 and Jamie Pinto, MD, FAAP1, (1)Pediatrics, Jersey Shore University Medical Center, Neptune, NJ, (2)Pediatrics, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Purpose:

Family centered rounds (FCR) have been shown to improve parental satisfaction and outcomes for hospitalized children. The American Academy of Pediatrics published a policy statement in 2003 endorsing this rounding method. A recent survey of U.S. and Canadian pediatric hospitalists shows that FCR are the most common rounding style in academic hospitals. Hospital-based rounds are an essential part of resident education. As more pediatric residents are exposed to FCR, it is important to evaluate their opinions on this practice. The purpose of the present report is to evaluate pediatric residents’ perceptions of FCR in the inpatient setting.

Methods:

Residents from accredited pediatric residency programs in New Jersey (n=9) were asked to anonymously respond to a web-based, survey questionnaire. A letter was sent to program directors, alerting them to the survey. The survey consisted of 37 close-ended or likert scale questions that assessed year of training, rounding practices in the trainees’ hospital and their perceptions of the impact of FCR on communication, quality of care, resident teaching, efficiency and resident comfort. A descriptive analysis was performed. Regression models were used to see if year of training or rounding type experienced had an effect on resident responses.

Results:  

Among 102 respondents (38% response rate), 20% practice FCR, 11% traditional/conference room rounds (TR) and 69% a combination of FCR and TR. There was no significant difference in distribution of trainees in respect to year of training between rounding categories. The majority of respondents believe FCR improves communication between the medical team and families (87%) and feel it creates stronger alliances with families (72%). Respondents report FCR benefits their pediatrics training (63.4%) and that it improves non-didactic teaching, didactic teaching and clinical decision making (68%, 46% and 41.1%, respectively). Longer rounding times in association with FCR are reported by 70.5% of respondents; while 63.3% agree that FCR decreases the amount of times they get called back into a room to clarify the plan. Residents agree that attending physicians’ styles greatly impact their experience on FCR (90%) and answering questions wrong affects rapport with families (73%). Moreover, respondents report they are more likely to omit sensitive information during FCR (75%) and are less likely to ask an attending a question on management when a family is present (67%). Regression models show that participant responses are not impacted by year in training or type of rounding practice experienced.

Conclusion:

Although pediatric residents agree that FCR are beneficial to families, factors including attending physician style, resident discomfort and efficiency of rounding may prevent full resident acceptance of FCR as a teaching strategy. Overcoming the barriers identified by the present study may benefit faculty development and residency educational programs for successful implementation of FCR at pediatric teaching hospitals.