An Approach to Intensive Care Unit Rounds Utilizing 5, 10, and 15-Minute Strategies.

Teaching medical rounds in intensive care units (ICUs) are essential for resident education. However, the ICU's high workload can hinder these rounds. We propose a new approach that is based on the constructivist theory of learning communities. This approach emphasizes active, collaborative learning through interaction. In the ICU, it encourages active learning, peer interaction, and shared responsibility among residents. Our model involves structured teaching rounds that promote active learning, collaboration, and reflection, all integrated into the ICU workflow. This new approach aims to enhance the learning experience; improve teaching round effectiveness; and, ultimately, contribute to better patient care.

Think-aloud approach combined with case-based learning in nursing teaching round for new nurses in cancer hospital.

BACKGROUND: The transition from nursing students to working as new nurses can be a challenging process. This study aimed to assess the efficacy of a pedagogical approach amalgamating the think-aloud approach and case-based learning in the instructional rounds for new nurses. METHODS: Utilizing convenience sampling, new nurses were selected between 2020 and 2021 in China cancer hospital. A total of 98 participants agreed to participate, with 50 enrolled in 2020 as the control group and 48 in 2021 as the observation group. Across a span of weeks 1, 3, 5, 7, 9, and 11, each clinical department conducted six teaching rounds. The observation group engaged in teaching rounds combining the think-aloud approach with case-based learning, whereas the control group solely utilized case-based learning. Disparities in case analysis scores and critical thinking ability between the two groups were scrutinized, alongside an analysis of learning strategies and the observation group feedback. RESULTS: The observation group exhibited superior case analysis scores (91.92 ± 6.33) and overall critical thinking ability scores (308.39 ± 35.88) in comparison to the control group, which scored (85.27 ± 5.39) and (275.11 ± 31.32) respectively, reflecting statistically significant variances (t = 1.868 ~ 6.361, P < 0.05). Predominant learning strategies employed in the observation group ranged from cognitive to meta-cognitive, followed by psychosocial strategies. During interviews focused on nurses' feedback on the learning process, themes emerged surrounding the enhancement of learning proficiency, invigoration of learning enthusiasm, and bolstering psychological well-being. CONCLUSION: The combination of think-aloud approach and case-based learning in nursing teaching rounds greatly improves the efficiency of training and the critical thinking acuity of new nurses. Concurrently, it facilitated an evaluation of learning strategies, thereby offering valuable insights for the nursing teaching rounds of new nurse.

Retrieving Rare Cases: A Protocol for Searching Complex Medical Cases.

This study sought to provide a protocol for searching complex medical cases of grand rounds. A clinical informationist was embedded in gastroenterology grand rounds to use comprehensive search strategies and summarize patients' information through concept mapping. Our proposed protocol classifies into three categories: (1) The general search strategy, (2) The protocol for searching for evidence about rare diseases, and (3) Identifying other resources more than routine medical databases. This approach represents a novel method beyond previous studies which were focused on usual ward rounds to facilitate evidence-based decision-making by providing and simplifying a comprehensive summary view of complex medical cases.

Extraneous Load, Patient Census, and Patient Acuity Correlate With Cognitive Load During ICU Rounds.

BACKGROUND: Cognitive load theory asserts that learning and performance degrade when cognitive load exceeds working memory capacity. This is particularly relevant in the learning environment of ICU rounds, when multidisciplinary providers integrate complex decision-making and teaching in a noisy, high-stress environment prone to cognitive distractions. RESEARCH QUESTION: What features of ICU rounds correlate with high provider cognitive load? STUDY DESIGN AND METHODS: This was an observational, multisite study of multidisciplinary providers during ICU rounds. Investigators recorded rounding characteristics and hourly extraneous cognitive load events during rounds (defined as distractions, episodes of split-attention or repetition, and deviations from standard communication format). After rounds, investigators measured each provider's cognitive load using the provider task load (PTL), an instrument derived from the National Aeronautics and Space Administration Task Load Index survey that assesses perceived workload associated with complex tasks. Relationships between rounding characteristics, extraneous load, and PTL score were evaluated using mixed-effects modeling. RESULTS: A total of 76 providers were observed during 32 rounds from December 2020 to May 2021. The mean rounding census ± SD was 12.5 ± 2.9 patients. The mean rounding time ± SD was 2 h 17 min ± 49 min. The mean extraneous load ± SD was 20.5 ± 4.5 events per hour, or one event every 2 min 51 s. This included 8.6 ± 3.4 distractions, 8.2 ± 4.2 communication deviations, 1.9 ± 1.4 repetitions, and 1.8 ± 1.3 episodes of split-attention per hour. Controlling for covariates, the hourly extraneous load events, number of new patients, and number of higher acuity patients were each associated with increased PTL score (slope, 2.40; 95% CI, 0.76-4.04; slope, 5.23; 95% CI, 2.02-8.43; slope, 3.35; 95% CI, 1.34-5.35, respectively). INTERPRETATION: Increased extraneous load, new patients, and patient acuity were associated with higher cognitive load during ICU rounds. These results can help direct how the ICU rounding structure may be modified to reduce workload and optimize provider learning and performance.

Something Lost and Something Gained: Navigating the Bedside Teaching Role as a Hospice and Palliative Medicine Educator.

Hospice and palliative medicine (HPM) educators must often give up the satisfaction of working one-on-one with patients, to allow learners the opportunity to practice key communication skills and form their own therapeutic bonds with patients. Though the loss of that primary relationship with patients may feel challenging, educators may find new opportunity for professional impact and satisfaction by investing in their relationship with learners. This case discussion explores the challenges of bedside teaching in HPM, including the educator's looser connection with patients, need to withhold their own communication skills, and decision of when to interject into a trainee-patient conversation. We then propose strategies to help educators find renewed professional fulfillment in the teacher-learner relationship. By partnering intentionally with learners before, during, and after shared visits, inviting informal reflection between encounters, and preserving independent clinical time, we believe educators may cultivate a more sustainable and meaningful clinical teaching practice.

What is impacting clinical pharmacists' participation in an interprofessional ward round: a thematic analysis of a national survey.

The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists' participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists' participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke's techniques. Five themes were constructed: "Clinical pharmacy service structure", "Ward round structure", "Pharmacist's capabilities", "Culture" and "Value". A culture supportive of pharmacist's contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists' participation in WR. Being physically "absent" from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual's role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.

Family Presence on Rounds in Adult Critical Care: A Scoping Review.

Family presence on rounds involves allowing family members to participate in daily healthcare team rounds and is recommended by critical care professional societies. Yet, family presence on rounds is not performed in many institutions. There is a need to synthesize the current evidence base for this practice to inform healthcare providers of the potential benefits and challenges of this approach. The main objective of this study was to explore the impact of family presence on adult ICU rounds on family and healthcare providers. DATA SOURCES: Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and PubMed databases were last searched on January 28, 2022. Studies published during the COVID-19 pandemic were included. STUDY SELECTION: Studies involving family presence during rounds that included family or healthcare provider perspectives or outcomes were selected. There were no limitations on study design. DATA EXTRACTION: Qualitative and quantitative family and provider perspectives, barriers and challenges to family presence, and study outcomes were extracted from studies. The JBI Manual for Evidence Synthesis published guidelines were followed. DATA SYNTHESIS: There were 16 studies included. Family reported family presence on rounds as a means of information transfer and an opportunity to ask care-related questions. Family presence on rounds was associated with increased family satisfaction with care, physician comfort, and improved physician-family relationship. Healthcare providers reported a positive perception of family presence on rounds but were concerned about patient confidentiality and perceived efficacy of rounds. Family presence was found to increase rounding time and was felt to negatively impact teaching and opportunities for academic discussions. CONCLUSIONS: Family presence on rounds has potential advantages for family and healthcare providers, but important challenges exist. Further studies are needed to understand how to best implement family presence on adult ICU rounds.

Standardization of rounds on a general paediatric ward: Implementation of a checklist to improve efficiency, quality of rounds, and family satisfaction.

Objective: The purpose of this study was to develop a standardized rounding tool for use on the general paediatric ward and to determine if its use can improve quality of rounds as well as patient and parent satisfaction. Methodology: The study used a pre- and post-intervention prospective observational methodology. The intervention consisted of the implementation of a Checklist Rounding Tool (CRT) entitled the 'Paediatric Inpatient Rounding Checklist (PIRC)' which outlined items deemed essential to discuss during rounds for all patients admitted to the paediatric ward. The PIRC was created by the research team after reviewing the literature and it was peer reviewed by a panel of expert paediatricians. Performance on rounds based on discussion of checklist items as well as patient and parent satisfaction were evaluated by an external observer both pre- and post-PIRC implementation. Results: Four of the five less frequently addressed checklist items were discussed significantly more post-intervention. The Rounds Quality Score was significantly improved after checklist implementation, the pre- and post-intervention scores being 8.24 and 9.61/10, respectively (P-value <0.001). Patient and parent satisfaction were rated higher with the use of the checklist. There was no difference in the duration of rounds between the pre- and post-implementation phases. Conclusion: In summary, utilization of a standardized rounding tool on an inpatient paediatric ward led to improvement in quality of rounds as well as patient and parent satisfaction.

Beyond satisfaction: evaluating understanding in PICU family centered rounds.

BACKGROUND: Many hospitals have adopted Family Centered Rounds (FCR), as a means to optimize communication. While studies show FCR improves family satisfaction, research on the impact on family understanding of their child's care has been conflicting. Understanding is particularly important when families are asked to share in complex decision making, as occurs in the Pediatric Intensive Care Unit (PICU). This study explores families' experiences of FCR in the PICU and examines how FCR impacts their understanding of their child's care. METHODS: We conducted surveys and interviews of family members after they attended FCR in two PICUs. The survey assessed families' satisfaction with rounds and their understanding across three domains: the child's illness, treatments, and prognosis. Physicians completed a similar survey to examine concordance with families' understanding. In interviews we explored underlying factors. We identified themes from transcripts through thematic analysis. RESULTS: Twenty-five family members completed the survey and participated in interviews. The majority (82%) rated their satisfaction with FCR highly. Discordance between families and physicians in understanding was common, especially in the prognosis domain, with concordance rates as low as 27%. We identified four themes from interviews that shed light on families' experiences and the relationship between FCR and understanding: Jargon, Feeling Part of the Team, Rounds as Overwhelming and Competing Purposes of Rounds. CONCLUSION: Families in our study had similar satisfaction with FCR as previously reported, yet our findings suggest that FCR can be optimized to achieve family understanding. Our findings provide insights into potential ways to accomplish this.

Do disadvantaged schools have poorer teachers? Rethinking assumptions about the relationship between teaching quality and school-level advantage.

Improving educational performance, including narrowing equity gaps, is frequently touted as a matter of improving the quality of teachers in the lowest performing, often disadvantaged, schools. However, the assumption that teaching is of poorer quality in disadvantaged schools is largely unsubstantiated. Using the Quality Teaching Model of pedagogy, we observed 832 lessons in 193 New South Wales primary schools and found a small relationship between teaching quality and school-level advantage. However, when 174 teachers from across the school spectrum participated in Quality Teaching Rounds we found equivalent, and substantial, gains in teaching quality across all levels of school advantage. This result indicates that differences in teaching quality are less a reflection of teacher capabilities than of the challenging circumstances in disadvantaged schools. We argue that policies seeking more equitable achievement should address wider social inequities, rather than unfairly blaming teachers for being unable to level an unequal playing field.

Effects of multidisciplinary rounds and checklist in an Intensive Care Unit: a mixed methods study / Efectos de las rondas multidisciplinarias y la lista de verificación en la Unidad de Cuidados Intensivos: un estudio de método mixto / Efeitos de rounds multidisciplinares e checklist em Unidade de Terapia Intensiva: estudo de método misto

ABSTRACT Objectives: to analyze the implementation of multidisciplinary checklist-directed rounds before health indicators and multidisciplinary team perception of an Intensive Care Unit. Methods: a mixed methods study, with an explanatory sequential design, carried out at a hospital in southern Brazil, from September 2020 to August 2021. The integration of quantitative and qualitative data was combined by connection. Results: after the implementation of checklist-directed rounds, there was a significant reduction in hospital stay from ventilator-associated pneumonia, urinary tract infection and daily invasive device use. The investigated practice is essential for comprehensive care, harm reduction, effective work and critical patient safety. Conclusions: the multidisciplinary rounds with checklist use reduced data on health indicators of critically ill patients and was considered a vital practice in the intensive care setting.

RESUMEN Objetivos: analizar la implementación de rondas multidisciplinarias guiadas por checklist frente a indicadores de salud y la percepción del equipo multidisciplinario de una Unidad de Cuidados Intensivos. Métodos: estudio de método mixto, con diseño secuencial explicativo, realizado en un hospital del sur de Brasil, de septiembre de 2020 a agosto de 2021. La integración de datos cuantitativos y cualitativos se combinó por conexión. Resultados: después de la implementación de las rondas dirigidas por listas de verificación, hubo una reducción significativa en la estancia hospitalaria por neumonía asociada a ventilación mecánica, infección del tracto urinario y en los días de uso de dispositivos invasivos. La práctica investigada es fundamental para la atención integral, la reducción de daños, el trabajo eficaz y la seguridad del paciente crítico. Conclusiones: las rondas multidisciplinarias con el uso de listas de verificación redujeron los datos sobre los indicadores de salud de los pacientes críticos y se consideró una práctica vital en el entorno de cuidados intensivos.

RESUMO Objetivos: analisar a implementação de rounds multidisciplinares direcionados por checklist frente aos indicadores de saúde e a percepção da equipe multiprofissional de uma Unidade de Terapia Intensiva. Métodos: estudo de método misto, com desenho sequencial explanatório, realizado em um hospital do sul do Brasil, no período de setembro de 2020 a agosto de 2021. A integração dos dados quantitativos e qualitativos foi combinada por conexão. Resultados: após a implementação dos rounds direcionados por checklist, constatou-se redução significativa no tempo de internação por pneumonias associadas à ventilação mecânica, infecção do trato urinário e nos dias de uso de dispositivos invasivos. A prática investigada é essencial para o cuidado integral, a redução de danos, o trabalho eficaz e a segurança do paciente crítico. Conclusões: os rounds multidisciplinares com uso de checklist reduziram os dados dos indicadores de saúde de pacientes críticos e foi considerado como prática vital no cenário de cuidados intensivos.

Multiprofessional round with checklist: association with the improvement in patient safety in intensive care / Ronda multiprofesional con checklist: asociación con la mejora en la seguridad del paciente en cuidados intensivos / Round multiprofissional com checklist: associação com a melhoria na segurança do paciente em terapia intensiva

ABSTRACT Objective To verify the association between a multiprofessional round with the use of checklists and patient safety practices by health professionals in an intensive care unit. Method Mixed-method study, delineated by the sequential explanatory approach, conducted in a hospital in southern Brazil. Quantitative data were analyzed using Poisson regression, and qualitative data, using content analysis. The integrated analysis was performed through the explained/connected combination. Results In the post-implementation period of the rounds with systematic use of the checklist, there was a significant improvement in the prophylaxis of venous thromboembolism, light sedation, reduction in the days of use of mechanical ventilation, central venous catheter and indwelling urinary catheter. Conclusion The multiprofessional round with the systematic use of checklist, associated with the improvement in patient safety practices, was considered as a strategy that ensures better care in intensive care and favors job satisfaction.

RESUMEN Objetivo Verificar la asociación entre una ronda multiprofesional con el uso de listas de verificación y prácticas de seguridad del paciente por profesionales de la salud en una unidad de cuidados intensivos. Método Estudio de método mixto, delineado por el enfoque explicativo secuencial, realizado en un hospital del sur de Brasil. Los datos cuantitativos se analizaron mediante regresión de Poisson, y los datos cualitativos, mediante análisis de contenido. El análisis integrado se realizo através de la combinación explicada/conectada. Resultados En el período de post-implementación de las rondas con uso sistemático del checklist, hubo una mejora significativa en la profilaxis del tromboembolismo venoso, sedación leve, reducción de los días de uso de ventilación mecánica, catéter venoso central y catéter urinario permanente. Conclusión La ronda multiprofesional con el uso sistemático de la lista de verificación, asociada a la mejora en las prácticas de seguridad del paciente, fue considerada como una estrategia que asegura una mejor atención en cuidados intensivos y favorece la satisfacción laboral.

RESUMO Objetivo Verificar a associação entre round multiprofissional com uso de checklist e práticas de segurança do paciente por profissionais de saúde de uma unidade de terapia intensiva. Método Estudo de método misto, delineado pela abordagem sequencial explanatória, realizado em um hospital do sul do Brasil. Os dados quantitativos foram analisados por meio de regressão de Poisson e os dados qualitativos, pela análise de conteúdo. Fez-se a análise integrada por meio da combinação explicada/conectada. Resultados No período pós-implementação dos rounds com uso sistemático de checklist houve melhora significativa da profilaxia de tromboembolia venosa, sedação leve, redução dos dias de uso de ventilação mecânica, cateter venoso central e de sonda vesical de demora. Conclusão O round multiprofissional com uso sistemático de checklist, associado com a melhoria nas práticas de segurança do paciente, foi considerado como uma estratégia que assegura melhores cuidados em terapia intensiva e favorece a satisfação no trabalho.

Nursing Education in a Real-Life Context: The Teaching Ward Round.

Education in nursing is continually changing. The didactic methods used in other fields may be useful for closing the gap between theoretical learning and the reality of practical nursing. This study aimed to determine the association between a teaching model centered on the reality of nursing care, which is individualized to each context, and knowledge acquisition. A controlled experimental study was conducted with random allocation to two groups of students in their second year of a nursing degree (University of Jaén). The control group undertook practical work placements according to the traditional model. The intervention group participated in a "teaching round" during their practical placements. Knowledge tests were conducted after the placements. No significant differences were found for age or education level between the students of the control group (n = 46) and the intervention group (n = 48). In terms of the association between participation in the teaching round and the knowledge test (maximum score of 10), the mean grade in the intervention group was 8.83 ± 0.22, while it was 7.68 ± 0.23 in the control group (p = 0.001). The teaching round increased the student's acquisition of knowledge, even though this was not reflected in the global grade of the course.

Mobile learning in clinical settings: unveiling the paradox.

PURPOSE: The use of mobile devices among medical students and residents to access online material in real-time has become more prevalent. Most literature focused on the technical/functional aspects of mobile use. This study, on the other hands, explored students, doctors and patients' preferences and reasons towards the use of mobile devices in clinical settings underpinned by the Technology Acceptance Model 2 (TAM 2). METHODS: This research employs an exploratory research design using survey and semi-structured interviews. An online survey was administered to clinical year medical students, followed by semi-structured interviews with the doctors and patients. Questions for the online survey and semi-structured interviews were derived from previous literature and was then reviewed by authors and an expert panel. A convenience sampling was used to invite voluntary participants. RESULTS: Survey findings showed that most medical students used their devices to find drug information and practice guidelines. The majority of the students accessed UpToDate followed by Google to access medical resources. Key barriers that students often encountered during the use of mobile devices were internet connectivity in the clinical settings, reliability of the information, and technical issues. Thematic analysis of the interviews revealed four themes: general usage by students, receptivity of the use of mobile devices by students, features in selecting resources for mobile learning, and limitation in the current use of mobile devices for learning. CONCLUSION: The findings from this study assist in recommending suitable material using mobile devices to enhance learning in the clinical environment and expand the TAM 2.

Experiências de enfermeiros de unidades pediátricas de um hospital universitário em relação às visitas multiprofissionais / Multidisciplinary visits in the experience of nurses in pediatric units of a university hospital / Experiencias de enfermeros en unidades pediátricas de un hospital universitario en relación con las visitas multiprofesionales

Objetivo: descrever a experiência dos enfermeiros atuantes nas unidades pediátricas frente às visitas multidisciplinares, compreender a percepção dos enfermeiros a respeito da participação da família nas visitas multidisciplinares e descrever as percepções dos enfermeiros residentes sobre o impacto das visitas multidisciplinares em sua formação profissional e no cuidado ao paciente e à família. Método: estudo qualitativo, realizado com 18 enfermeiros de unidades pediátricas de um hospital universitário, a partir de entrevistas semi-estuturadas, com uso da análise de conteúdo. Resultados: a experiência foi compreendida pelas categorias: Formato da visita multidisciplinar; Participação do enfermeiro na visita multidisciplinar; Participação da família na visita multidisciplinar; Benefícios da visita para o enfermeiro, residente e família; e Recomendações para os enfermeiros, família e desenho das visitas. Conclusão: a experiência dos enfermeiros é representada essencialmente pelas relações humanas estabelecidas, com benefícios ou prejuízos à sua participação e participação da família. A visita multidisciplinar constitui uma prática benéfica e com potencial formativo.

Objective: to describe how nurses working in pediatric units experienced multidisciplinary visits, to understand their perceptions of the families' participation in such visits, and the residents' perceptions of the visits' impact on training and on care for patients and families. Method: this qualitative, descriptive study involving 18 male nurses from pediatric units of a university hospital, was conducted through semi-structured interviews, using content analysis. Results: the nurses' experience was understood by categories: the design of multidisciplinary visits; nurses' participation in multidisciplinary visits; families' participation in multidisciplinary visits; benefits from visits for nurses, residents and families; and recommendations for nurses and families, and for visit design. Conclusion: the nurses' experience was essentially represented by the human relationships established, and the related benefits or detriments to participation by themselves and the families. The visit was found to be a beneficial practice with training potential.

Objetivo: describir la experiencia de enfermeros que laboran en unidades de pediatría antes las visitas multidisciplinarias, comprender la percepción de los enfermeros sobre la participación familiar en las visitas multidisciplinarias y describir las percepciones de los enfermeros residentes sobre el impacto de las visitas multidisciplinarias en su formación profesional y en la atención al paciente y la familia. Método: estudio cualitativo, junto a 18 enfermeros de unidades de pediatría de un hospital universitario, realizado a partir de entrevistas semiestructuradas, mediante análisis de contenido. Resultados: la experiencia fue entendida por las categorías: Formato de la visita multidisciplinaria; Participación del enfermero en la visita multidisciplinaria; Participación de la familia en la visita multidisciplinaria; Beneficios de la visita para el enfermero, el residente y la familia; y Recomendaciones para enfermeros, familia y diseño de las visitas. Conclusión: la experiencia de los enfermeros está esencialmente representada por las relaciones humanas establecidas, con beneficios o perjuicios a su participación y la participación familiar. La visita multidisciplinaria es una práctica beneficiosa con potencial formativo.

Experiências de enfermeiros de unidades pediátricas de um hospital universitário em relação às visitas multiprofissionais / Experiencias de enfermeros en unidades pediátricas de un hospital universitario en relación con las visitas multiprofesionales / Multidisciplinary visits in the experience of nurses in pediatric units of a university hospital

RESUMO Objetivo descrever a experiência dos enfermeiros atuantes nas unidades pediátricas frente às visitas multidisciplinares, compreender a percepção dos enfermeiros a respeito da participação da família nas visitas multidisciplinares e descrever as percepções dos enfermeiros residentes sobre o impacto das visitas multidisciplinares em sua formação profissional e no cuidado ao paciente e à família. Método estudo qualitativo, realizado com 18 enfermeiros de unidades pediátricas de um hospital universitário, a partir de entrevistas semi-estuturadas, com uso da análise de conteúdo. Resultados a experiência foi compreendida pelas categorias: Formato da visita multidisciplinar; Participação do enfermeiro na visita multidisciplinar; Participação da família na visita multidisciplinar; Benefícios da visita para o enfermeiro, residente e família; e Recomendações para os enfermeiros, família e desenho das visitas. Conclusão: a experiência dos enfermeiros é representada essencialmente pelas relações humanas estabelecidas, com benefícios ou prejuízos à sua participação e participação da família. A visita multidisciplinar constitui uma prática benéfica e com potencial formativo.

RESUMEN Objetivo describir la experiencia de enfermeros que laboran en unidades de pediatría antes las visitas multidisciplinarias, comprender la percepción de los enfermeros sobre la participación familiar en las visitas multidisciplinarias y describir las percepciones de los enfermeros residentes sobre el impacto de las visitas multidisciplinarias en su formación profesional y en la atención al paciente y la familia. Método: estudio cualitativo, junto a 18 enfermeros de unidades de pediatría de un hospital universitario, realizado a partir de entrevistas semiestructuradas, mediante análisis de contenido. Resultados la experiencia fue entendida por las categorías: Formato de la visita multidisciplinaria; Participación del enfermero en la visita multidisciplinaria; Participación de la familia en la visita multidisciplinaria; Beneficios de la visita para el enfermero, el residente y la familia; y Recomendaciones para enfermeros, familia y diseño de las visitas. Conclusión la experiencia de los enfermeros está esencialmente representada por las relaciones humanas establecidas, con beneficios o perjuicios a su participación y la participación familiar. La visita multidisciplinaria es una práctica beneficiosa con potencial formativo.

ABSTRACT Objective to describe how nurses working in pediatric units experienced multidisciplinary visits, to understand their perceptions of the families' participation in such visits, and the residents' perceptions of the visits' impact on training and on care for patients and families. Method this qualitative, descriptive study involving 18 male nurses from pediatric units of a university hospital, was conducted through semi-structured interviews, using content analysis. Results the nurses' experience was understood by categories: the design of multidisciplinary visits; nurses' participation in multidisciplinary visits; families' participation in multidisciplinary visits; benefits from visits for nurses, residents and families; and recommendations for nurses and families, and for visit design. Conclusion: the nurses' experience was essentially represented by the human relationships established, and the related benefits or detriments to participation by themselves and the families. The visit was found to be a beneficial practice with training potential.

Evaluating the impact of a "grand rounds" elective course on students' perceived motivations, comfort, and confidence in providing constructive and reinforcing feedback to guest lecturers.

BACKGROUND AND PURPOSE: Providing feedback is an important skill for all healthcare professionals both within and outside of their discipline. Although student pharmacists frequently receive feedback during both didactic and experiential education, training on how to provide feedback to others is less common. EDUCATIONAL ACTIVITY AND SETTING: An elective was designed to expose second-year pharmacy students to "grand rounds" with practicing pharmacists as the presenters. Students provided feedback to presenters on presentation style and assessment questions. The primary objective of this research project was to determine if the elective improved students' motivations, comfort, and confidence in providing constructive written feedback. FINDINGS: Over two course offerings, 54% (19 of 35) of enrolled students completed both the pre- and post-surveys. At baseline, the majority of students self-identified as being motivated, comfortable, and confident with providing quality written feedback with the exception of two specific areas: motivation to provide quality written feedback and comfort with providing difficult or sensitive written feedback. At the end of the course, the majority of students self-identified as being motivated, comfortable, and confident across all areas queried. All students agreed or strongly agreed that the efficiency and quality of their written feedback improved during the course. SUMMARY: The course offered several benefits to students, including learning clinical topics from a variety of presenters and developing feedback skills. The implementation of the grand rounds elective provided students an opportunity to develop their motivation, comfort, and confidence with providing quality constructive written feedback.

A mixed-methods assessment of the transition to a dedicated educational unit: nursing students' perceptions and achievements.

BACKGROUND: In 2019, our nursing school shifted clinical instruction from the traditional model to the Dedicated Educational Unit (DEU). OBJECTIVES: To evaluate the DEU learning atmosphere, instruction quality, clinical instructor's performance and students' grades. METHODS: A sample of 45 nursing students completed the CLES-T; 10 of them participated in a focus group. Students' grades in the DEU and traditional models were compared. RESULTS: Students (77.6%) ranked the DEU outcomes as "good"-"excellent;" "nursing care on the unit" and the "clinical faculty's ability to integrate theory and practice" were the highest and lowest ranked categories, respectively. The focus group revealed dichotomous opinions regarding the unit atmosphere and the professional performance of the nurse manager and staff. Students in the DEU framework attained higher grades than did their counterparts. CONCLUSIONS: Clinical instructors need specific training; the clinical staff and nurse managers should be informed about the unit atmosphere's impact on students' future professional decisions.

Percepción estudiantil sobre la guardia médica como forma de educación en el trabajo / Student perception on the doctor on duty system as a form of in- service training

RESUMEN Fundamento: la guardia médica en pregrado constituye un escenario formativo para la adquisición de habilidades y valores propios de la carrera de Medicina. Objetivo: valorar la guardia médica como forma de educación en el trabajo según la percepción de estudiantes de quinto año de Medicina. Método: se realizó una investigación descriptiva y transversal en la Universidad de Ciencias Médicas de Pinar del Río durante 2019-2020. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; empíricos: cuestionario a estudiantes mediante el cual se exploraron sus opiniones sobre la guardia médica. Los resultados obtenidos se llevaron a tablas para sus análisis, a los que se les aplicó el método porcentual. Resultados: los estudiantes consideraron la guardia médica como una forma de vincular la adquisición de conocimientos, habilidades y hábitos para la solución de los problemas de salud en la comunidad; las especialidades Cirugía, Ginecología y Otorrinolaringología fueron las más reconocidas por sus aportes a la profesión; señalaron como mayores habilidades obtenidas: interrogar al paciente, confeccionar historias clínicas y buscar factores de riesgo; la mayoría coincidieron en opinar sobre la efectividad del control y evaluación docentes, aunque persistieron algunas deficiencias metodológicas para lograr una mayor motivación en ellos. Conclusiones: los estudiantes percibieron la efectividad de la guardia médica como forma de educación en el trabajo en la carrera de Medicina, pues opinaron favorablemente sobre ella a partir de los aportes ofrecidos en cuanto a solidez del aprendizaje, y en la concepción y desarrollo de habilidades y valores profesionales.

ABSTRACT Background: the undergraduate medical student on duty system constitutes a formative scene for the acquisition of skills and values ​​of the Medicine degree. Objective: to assess the medical student on duty system as a form of in-service training according to the perception of fifth-year medical students. Method: a descriptive and cross-sectional research was carried out at Pinar del Río University of Medical Sciences from 2019 to 2020. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; empirical ones: questionnaire to students through which their opinions about the medical student on duty system were explored. The results were illustrated through tables where the percentage method was applied for analysis. Results: the students considered the medical on call system as a way to link the acquisition of knowledge, skills and habits for the solution of health problems in the community; Surgery, Gynecology and Otorhinolaryngology specialties were the most recognized for their contributions to the profession; They pointed out as greater skills obtained: questioning the patient, making medical records and looking for risk factors; The majority agreed in their opinion on the effectiveness of teacher control and evaluation, although some methodological deficiencies persisted in order to achieve greater motivation in them. Conclusions: the students perceived the effectiveness of the medical on call system as a form of in-service training in the Medicine degree, since they gave a favorable opinion about it based on the contributions offered in terms of solidity of learning and in the conception and development of skills and professional values.