title: The Importance of Situational Awareness: A Qualitative Study of Family Members' and Nurses' Perspectives on Teaching During Family-Centered Rounds.
abstract: OBJECTIVE
  Family-centered rounds (FCR) has become a leading model for pediatric inpatient rounding. During FCR, faculty must balance trainees' educational needs with patient care priorities. Investigators have examined trainees' views on effective teaching during FCR, but none have evaluated what family members and nurses consider to be effective teaching behaviors of attending physicians. The authors sought to explore family members' and nurses' perspectives on effective teaching behaviors during FCR.
  
  
  METHODS
  The authors conducted (2012-2013) a qualitative study of families and nurses at an academic children's hospital where FCR is the standard model for inpatient rounds. Nurses and families familiar with FCR participated in separate focus groups. The authors reviewed focus group transcripts using techniques of qualitative content analysis; they generated codes and developed categories, supported by illustrative quotations.
  
  
  RESULTS
  Fifteen nurses and 13 family members participated in the focus groups. The unifying theme was that situational awareness on behalf of the attending physician is essential for FCR to be educational for all participants. The authors identified four categories of awareness-(1) cognitive factors, (2) logistics and time management, (3) physical environment, (4) emotional state-and developed a set of effective teaching strategies based on participants' comments.
  
  
  CONCLUSIONS
  The findings of this study support previous work identifying effective FCR teaching strategies, but this study is the first to include the perspectives of families and nurses. The inclusion of these participants provides a framework for faculty development and training to improve the educational value of FCR.
authors.affiliation: J. Beck is acting assistant professor of pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Division of Pediatric Hospital Medicine, Seattle, Washington. At the time of this study, he was a pediatric hospital medicine fellow, Division of Hospital Medicine, Children's National Health System, Washington, DC.R. Meyer is neonatal hospitalist, University of California, San Diego Medical Center, San Diego, California. At the time of this study, she was a third-year pediatric resident, Children's National Health System, Washington, DC.T. Kind is associate professor of pediatrics, George Washington University School of Medicine and Health Sciences, Children's National Health System, Division of General Pediatrics and Community Health, Washington, DC.P. Bhansali is assistant professor of pediatrics, George Washington University School of Medicine and Health Sciences, Children's National Health System, Division of Pediatric Hospital Medicine, Washington, DC.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Beck
authors.forename: Rebecca
authors.initials: R
authors.lastname: Meyer
authors.forename: Terry
authors.initials: T
authors.lastname: Kind
authors.forename: Priti
authors.initials: P
authors.lastname: Bhansali
mesh_terms: D001290:Attitude; D001291:Attitude of Health Personnel; D003071:Cognition; D003142:Communication; D004644:Emotions; D004777:Environment; D005190:Family; D017144:Focus Groups; D006801:Humans; D009726:Nurses; D010358:Patient Participation; D010362:Patients' Rooms; D010372:Pediatrics / Q000193:education*; D000068616:Professionalism; D036301:Qualitative Research; D056164:Teaching Rounds / Q000379:methods*; D017748:Time Management