Article Review - Teachable moments, learnable moments: Medical Rounds as a paradigm for education

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?