de Luise, V. P. (2014). Teachable moments,
learnable moments: Medical Rounds as a paradigm for education. Mind, Brain, and Education, 8(1), 3-5.
Background:
Medical rounds have been utilized throughout the
century as a pedagogical tool that allows physicians, physician-in-training,
and their teams to engage in shared knowledge that informs the clinical
diagnosis and treatment of patients. Medical rounds have been suggested as an
effective strategy for administrators in the field of education to better understand
their field.
Purpose:
The article aim was to provide an analysis of the
four types and functions of medical rounds, (1) morning rounds, (2) chart
rounds, (3) grand rounds, and (4) ongoing collaborations to determine the
utility for the field of education.
Definitions:
Morning Rounds – Daily
episode where an attending physician, physicians-in-training, interns, nurses
and others walk through a specified area of interest within the hospital
visiting the bedside of each patient on the teams watch. The team engages in a
sharing of medically relevant information, discussion, and examination of each
patient throughout the walk; Afternoon “Chart” Rounds – a privately held
discussion about the status of each patient since morning rounds; Grand Rounds
– presentations of specific medical cases and supporting literature delivered
in an auditorium setting with the opportunity for discussion between physicians
and physicians-in-training; Ongoing Collaboration – informal chat sessions,
usually in a lounge or cafeteria, where physicians and researchers share ideas
Key Points:
Evidence suggests that
medical students learn differently depending on who is doing the teaching.
Morning rounds represent a distinct differentiation between the teacher and the
learner, but the physician-in-training’s contribution to the discussion and
their ability to ask deeper questions allows them to also be the teacher.
Therefore, morning rounds are both top-down and bottom-up as they represent a
fluid model of shared information and learning.
Grand rounds represent
a top-down pedagogy delivered by expert physicians usually from a podium
allowing physicians-in-training the opportunity to ask questions and engage in
discussions to improve future patient care.
Conclusion: The
shared fluidity and complexity between teacher and learner serves as an
overarching theme to all four models of medical rounds. The teacher is just as
much informed during the process as the learner.
The utilization of a
more complex teaching-brain teaching model allows for an optimal teaching and
learning experience.
Implications: The integration of teachable
moments and pedagogical episodes as utilized in medical education could assist
in the development of a more ideal atmosphere that maximizes opportunities for
teaching and learning without compromising human interaction through the usage
of technology.
Questions
Raised: In what way could educators employ strategies from medical
rounds in a collaborative fashion in order to find effective solutions to
everyday problems within the classroom?
