The value of the post-take ward round: are new working patterns compromising junior doctor education?
This prospective observational study assessed the impact of the changes in junior doctors' working hours and waiting-time initiatives on teaching and learning opportunities for junior doctors in acute medicine. An audit cycle of post-take ward rounds including all medical admissions to an urban teaching hospital was conducted. During two seven-day periods in July 2006 and 2008, 317 and 354 patients were admitted respectively. In the two-year interval a number of changes were implemented resulting in a significant increase in patients reviewed by a consultant within 24 hours of admission. Target waiting times were being met but there were many missed learning opportunities for junior staff. Senior doctors continue to perform the majority of post-take reviews in the absence of the doctors who had admitted the patient. Similar patterns are likely to be found in other hospitals attempting to balance training with government targets for waiting times and junior doctors' working hours.
Chaponda
M
M
Infectious Diseases and Clinical Pharmacology, Royal Liverpool University Hospital, Liverpool. chaponda@liverpool.ac.uk
Borra
M
M
Beeching
N J
NJ
Almond
D S
DS
Williams
P S
PS
Hammond
M A
MA
Price
V A
VA
Tarry
L
L
Taegtmeyer
M
M
D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards*; D006801:Humans; D008330:Management Audit; D010362:Patients' Rooms; D010820:Physicians; D024382:Professional Role; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D006113:United Kingdom; D000078329:Workforce; D016526:Workload