Angkor Hospital for Children Faculty Development Course

Teaching Rounds
Proposed Changes Goals

Improve patient management Teach new skills/ideas Check out patients to on-call doctors Utilize volunteers

Key Responsibilities Senior On-Call (Senior) Lead teaching rounds (start, direct discussions, teach, finish on time) Offer their ideas but not manage the patient (rule but not govern) Pick specific ideas/points to teach each day Discuss with the Volunteer how they can contribute to rounds beforehand Give clear answers to the Juniors questions Summarize key learning points after each case Provide time for Juniors to ask Volunteers questions Encourage self-learning (have Juniors look conditions up) Provide feedback to the Juniors on their presentations and management decisions Chief Develop a patient management plan with the Junior Help the Junior write clear progress notes and make good patient presentations Use current protocols and lead the develop further protocol for common conditions Be available to explain the management plans on all patients Makes the final decisions about management Junior Review all patients with the Chief Make sure their orders are clear and carried out (performed) helping when necessary Practice their presentations before rounds Make sure all necessary elements of the presentation (lab results, chart, x-rays, etc.) are collected before rounds Make the patient management plan clear in the chart and during the presentation, especially with difficult patients Look up cases when possible and be prepared to offer some thoughts about patient management Schedule 11am Chief & Senior o Review main management points on difficult patients o Pick a few cases for teaching rounds o Discuss the role of the Volunteer for rounds o Identify where Juniors may need more help/input o Follow-up on issues from previous day (assignments given to Juniors, continuation of discussions) 2-3:30pm Teaching Rounds (ICU&IPD) o Review all patients briefly (1-2 minutes) o Focus on a few difficult or interesting teaching cases o Senior should manage the time well so that rounds are completed on time (ideally within one hour) 3:30-4pm Individual Teaching o Senior available to provide feedback, answer questions or demonstrate skills to Juniors

Angkor Hospital for Children Faculty Development Course

Format of Rounds How rounds are conducted is up to the Senior On-Call. They are encouraged to be creative to keep rounds interesting and engaging. Examples of different formats for rounding includes: o Sit-down: Can present patients and use the whiteboard for discussion seated at the table, then go to the bedside afterwards for a few key teaching cases. o Corridor: Current form of rounds where everyone can see the patient from a distance. o Bedside: Can be very effective with a smaller group. Also beneficial when you can engage the patient and family in the process. Other ideas for the future Procedure log - ekg, x-ray, ultrasound, lines/catheters, intubation, vent management Regular evaluations (after each rotation for Chief, seniors and juniors) Teaching Awards & Junior Awards Next Step Formally present at Med Ed meeting, March 3rd (Leakhena to coordinate with Varun)