Teaching and learning on busy post-take ward rounds

摘要

I read with interest the article by Graeme Dewhurst (Clin Med June 2010 pp 231-4). In the article, Dewhurst investigates those factors which are considered by junior doctors to hinder and encourage learning and teaching opportunities on post-take ward rounds. Ward rounds have always been an essential part of postgraduate medical education since first described in 1660. In the mid-1980s a survey reported that 58% of senior house officers' learning occurred on ward rounds. However, medical education has been turned on its head in recent years with the adoption of the European Working Time Directive and the implementation of Modernising Medical Careers and the foundation year (FY) programme. In a recent study I found that only 18% of FY doctor learning occurs on ward rounds and I suspect that the issues outlined by Dewhurst play a major role in this decrease, noticeably, reduced time, reduced team cohesion and lack of awareness of learning and teaching skills.