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Learning clinical communication on ward-rounds: An ethnographic case study.
Med Teach. 2014 Aug 26;:1-6
Authors: Quilligan S
Abstract
Abstract Objective: To explore what factors influence student-doctors' learning of clinical communication on ward-rounds and how such learning can be enhanced. Methods: Adopting a qualitative ethnographic approach, the author audio recorded and observed 63 bedside episodes within 18 ward-rounds on four different wards over an 8-week period. Nine fourth year student-doctors and four clinicians also participated in semi-structured interviews. The combination of observations, audio-recordings, transcriptions, field notes, and interview data allowed us to produce a detailed description of the case. Results: Each bedside episode offered opportunities for learning about clinical communication. However, the student-doctors did not always recognise that they were learning about clinical communication, since in this context, they were not being explicitly taught about communication. Student-doctors were rarely invited to participate in the ward-round and clinicians overlooked opportunities for learning. Some student-doctors questioned the educational value of ward-rounds and did not always attend. Conclusions: Ward-rounds are a rich site for learning clinical communication but opportunities for learning are often overlooked. Practice implications: By being alert to the power of role modelling and the importance of inclusion and participation, student-doctors' learning of clinical communication can be enhanced even on busy ward rounds.
PMID: 25154915 [PubMed - as supplied by publisher]