{"id":10606,"date":"2021-12-15T17:22:38","date_gmt":"2021-12-15T17:22:38","guid":{"rendered":"https:\/\/research.christianacare.org\/publications\/2021\/12\/15\/nephrology-fellows-and-program-directors-perceptions-of-hospital-rounds-in-the-united-states\/"},"modified":"2021-12-15T17:22:38","modified_gmt":"2021-12-15T17:22:38","slug":"nephrology-fellows-and-program-directors-perceptions-of-hospital-rounds-in-the-united-states","status":"publish","type":"post","link":"https:\/\/research.christianacare.org\/publications\/2021\/12\/15\/nephrology-fellows-and-program-directors-perceptions-of-hospital-rounds-in-the-united-states\/","title":{"rendered":"Nephrology Fellows&#8217; and Program Directors&#8217; Perceptions of Hospital Rounds in the United States"},"content":{"rendered":"<p>Boyle SM, Subedi K, Pivert KA, Harhay MN, Baynes-Fields J, Goldman J, Warburton KM<\/p>\n<p>Clin J Am Soc Nephrol 2020 04;15(4):474-483<\/p>\n<p>PMID: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32184295\" title=\"\">32184295<\/a><\/p>\n<h2>Abstract<\/h2>\n<p><p><strong>BACKGROUND AND OBJECTIVES&#8221;&gt;Hospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.&lt;\/Abstr:<\/strong> Hospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.<\/p>\n<p><strong>DESIGN, SETTING, PARTICIPANTS, &amp; MEASUREMENTS&#8221;&gt;We conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology&#8217;s 2019 Nephrology Training Program Directors&#8217; Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows&#8217; clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.&lt;\/Abstr:<\/strong> We conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology&#8217;s 2019 Nephrology Training Program Directors&#8217; Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows&#8217; clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.<\/p>\n<p><strong>RESULTS&#8221;&gt;Fellow and program director response rates were 73% (<i>n<\/i>=621) and 70% (<i>n<\/i>=55). Most fellows (74%) report a patient census of &gt;15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows&#8217; clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).&lt;\/Abstr:<\/strong> Fellow and program director response rates were 73% (=621) and 70% (=55). Most fellows (74%) report a patient census of &gt;15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows&#8217; clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).<\/p>\n<p><strong>CONCLUSIONS&#8221;&gt;Hospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.&lt;\/Abstr:<\/strong> Hospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.<\/p>\n<p><strong>PODCAST&#8221;&gt;This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2020_03_17_CJN.10190819.mp3.Copyright \u00a9 2020 by the American Society of Nephrology.&lt;\/CopyrightInfo:<\/strong> This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2020_03_17_CJN.10190819.mp3.<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Boyle SM, Subedi K, Pivert KA, Harhay MN, Baynes-Fields J, Goldman J, Warburton KM Clin J Am Soc Nephrol 2020 04;15(4):474-483 PMID: 32184295 Abstract BACKGROUND AND OBJECTIVES&#8221;&gt;Hospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.&lt;\/Abstr:<\/p>\n<p><a class=\"more-link\" href=\"https:\/\/research.christianacare.org\/publications\/2021\/12\/15\/nephrology-fellows-and-program-directors-perceptions-of-hospital-rounds-in-the-united-states\/\">Continue reading <span class=\"screen-reader-text\">Nephrology Fellows&#8217; and Program Directors&#8217; Perceptions of Hospital Rounds in the United States<\/span><\/a><\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[41],"tags":[],"class_list":["post-10606","post","type-post","status-publish","format-standard","hentry","category-ireach"],"acf":[],"_links":{"self":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/10606","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/comments?post=10606"}],"version-history":[{"count":0,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/posts\/10606\/revisions"}],"wp:attachment":[{"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/media?parent=10606"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/categories?post=10606"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/research.christianacare.org\/publications\/wp-json\/wp\/v2\/tags?post=10606"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}