title: Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA).
abstract: BACKGROUND
  The medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians' tasks and relevant competences for conducting a medical ward round on the first day of professional work.
  
  
  METHODS
  A review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme.
  
  
  RESULTS
  Nine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork.
  
  
  CONCLUSIONS
  The study is the first to picture ward round competences and related tasks in detail and to define an EPA "Conducting an internal medicine ward round" based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.
authors.affiliation: Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, Ziemssenstrasse 1, 80336, Munich, Germany.
authors.forename: Teresa
authors.initials: T
authors.lastname: Wölfel
authors.affiliation: Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, Ziemssenstrasse 1, 80336, Munich, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Beltermann
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Ziemssenstrasse 1, 80336, Munchen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Lottspeich
authors.affiliation: Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, Ziemssenstrasse 1, 80336, Munich, Germany.
authors.forename: Elisa
authors.initials: E
authors.lastname: Vietz
authors.affiliation: Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, Ziemssenstrasse 1, 80336, Munich, Germany.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Fischer
authors.affiliation: Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, Ziemssenstrasse 1, 80336, Munich, Germany. ralf.schmidmaier@med.uni-muenchen.de.|Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Ziemssenstrasse 1, 80336, Munchen, Germany. ralf.schmidmaier@med.uni-muenchen.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Schmidmaier
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003266:Continuity of Patient Care; D000068156:Formative Feedback; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards*; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology / Q000592:standards; D010819:Physician's Role; D019555:Physician-Nurse Relations; D010817:Physician-Patient Relations; D056164:Teaching Rounds / Q000592:standards*
keywords: Competency; Curriculum development; Entrustable professional activity; Internal medicine ward round; Teaching methods