Blog | Friday, July 7, 2017

The joy of teaching rounds


January 1980 I had my first experience as a teaching ward attending. I loved it. Thirty-seven years later, I love it.

I just spent most of four weeks traveling. This Monday I started a five-day stint rounding. Each day I am excited. As we discuss patients; as we see patients; I get more excited. Our patients provide our students and residents so many opportunities to learn.

Excellent inpatient internal medicine does require attention to many details. Sometimes we need to carefully take the history. Sometimes the physical exam gives us great information. Other times we need to best interpret the laboratory tests.

Sometimes we make diagnoses that make a huge difference. Or we help patients understand their illness and improve their adherence to high quality treatment. Often what we do is comfort patients who have a poor prognosis, but benefit from our caring.

During teaching rounds we work on many dimensions. Our first goal is to help our patients, but we also have a major responsibility to help our students and residents grow into great physicians.

We help our learners with attention to details, explaining why we do things, and role modeling bedside communications.

As I have traveled this spring, several times I have met with groups of clinician educators. Each time they want to discuss the process of teaching rounds.

I do believe that the process is not straightforward. From the questions they have asked, most clinician educator struggle to find their way.

I have colleagues who do a great job with teaching rounds. We do not all run our rounds the same. It seems obvious that the details of rounding style do not matter as much as how we treat our patients and our learners.

Learners want to understand. They prefer understanding to being told what to do.

When done right teaching rounds are magic. Teaching rounds convinced me that I should become an internist.

We need a strong cadre of clinician educators at every medical school and residency program. They should model their love for patient care and doing things right. That is my goal every time I go to rounds.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.