Identifying the challenges to good clinical rounds: A focus-group study of medical teachers

Introduction: The use of clinical rounds, as an integral part ofclinical teaching to help medical students acquire essential skillsof practicing medicine, is critically important. An understandingof medical teachers’ perceptions concerning the challenges ofclinical rounds can help identify the key areas of focus to betterfoster professional development of medical students. This studyexplored the opinions of medical teachers of Kerman Universityof Medical Sciences about the challenges embedded in clinicalrounds. There is a paucity of studies regarding the topic underinvestigation in our context.Methods: This qualitative study was conducted using aconventional content analysis method. We held a focus groupdiscussion with eight skilled bedside teachers, chosen usingpurposive sampling, from Kerman University of Medical Sciencesin February 2018. The focus group lasted for approximately2 hours. The session was audio-taped. We analyzed data byconsidering the verbatim transcribed document of the audiorecordeddiscussions using conventional content analysis methodfor theme development. Informed consent was obtained from theparticipants.Results: Medical teachers described many primary challenges toclinical rounds. Some of them were multiple students on roundingpractices, time constraints, priority of research and patient care toteaching, and lack of participation and enthusiasm. We categorizedthese varied challenges into 5 specific areas related to (1) system;(2) teachers; (3) learners; (4) patients; and (5) evaluation issues.Focus group participants expressed some suggestions to mitigatebarriers such as having fewer students on the rounds, addressingtime constraints through planning and flexibility, and the provisionof medical education award.Conclusion: Clinical round practices are valuable but repletewith a spectrum of problems. Many challenges affect the qualityof teaching in clinical rounds that should be taken into accountby bedside teachers in order to improve the quality of roundingpractices. The identified challenges can be used in redressingbedside teaching to have more efficient rounding practices.Keywords: Clinical, Focus group, Medical teachers