Teaching and learning in the hospital ward.
OBJECTIVE
To explore ways in which student learning during formal ward rounds can be enhanced.


METHODS
Qualitative study of University of Otago medical students (Dunedin, New Zealand) involving observation of surgical teams during formal ward rounds, and indepth interviews with students and consultant surgeons.


RESULTS
Teaching and learning opportunities on ward rounds were often missed by both clinical teachers and students as service provision and patient care took precedence. As a result, students often felt excluded and frequently expressed ambivalence about the educational value of formal whole team ward rounds. Students were more likely to consider themselves part of the team when they felt useful and were included in team discussions about patient care. They reported that they learned more effectively on smaller, more educationally focussed ward rounds that incorporated bedside tutorials and opportunities to practice examination skills.


CONCLUSIONS
Students and clinical teachers know that students need to make the most of learning opportunities by being proactive, spending time on the ward, being useful, asking questions. Clinical staff can facilitate student learning by consciously including students in the business of patient care. This means inviting students to ask questions and examine wounds, physically guiding hands on examinations, encouraging students to pay attention to discussions among the clinical team, and explaining what is being discussed.
Department of General Practice, University of Otago, PO Box 913, Dunedin, New Zealand. chrystal.jaye@otago.ac.nz
Chrystal
C
Jaye
Tony
T
Egan
Kelby
K
Smith-Han
Mark
M
Thompson-Fawcett
D001291:Attitude of Health Personnel; D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D003479:Curriculum; D013502:General Surgery / Q000193:education*; D006784:Hospitals, Teaching; D006801:Humans; D008487:Medical History Taking / Q000379:methods; D009520:New Zealand; D010348:Patient Care Team; D010362:Patients' Rooms; D010808:Physical Examination / Q000379:methods; D018794:Problem-Based Learning / Q000379:methods; D013503:Surgery Department, Hospital