title: Orthopedic grand rounds can change resident practice.
abstract: This study sought to determine whether a grand rounds presentation could change resident practice. A 6-month review of all hip fracture patients 65 years and older at a single academic medical center was performed. The rate of addressing advanced directives and code status as documented in the medical record was noted. A grand rounds presentation was then given to the orthopedic department, and the medical records of hip fracture patients for the 12 months following the grand rounds were reviewed. In the 6 months prior to the grand rounds, orthopedic residents did not document code status or advanced directives in any of their admission or consultation notes. Following the grand rounds, orthopedic residents addressed advanced directives, code status, and contact person in 76% of their admission notes. There was a marked difference in the rate of documentation among residents who attended the grand rounds (88%), compared with residents who did not attend grand rounds (20%). Based on the results of this study, specifically whether residents attended grand rounds, this form of teaching can lead to changes in resident behavior.
authors.affiliation: Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03755, USA. robert.v.cantu@hitchcock.org
authors.forename: Robert V
authors.initials: RV
authors.lastname: Cantu
authors.forename: Marcus P
authors.initials: MP
authors.lastname: Coe
authors.forename: David M
authors.initials: DM
authors.lastname: Pober
authors.forename: Ira R
authors.initials: IR
authors.lastname: Byock
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009985:Orthopedics / Q000193:education*; D010820:Physicians; D056164:Teaching Rounds