Unpacking the learning on consultant-led ward rounds: Lessons from ethnography in paediatrics

Authors

DOI:

https://doi.org/10.11157/fohpe.v21i3.336

Keywords:

ward round education, medical education, paediatrics, child health, learning and teaching, clinical learning, work-based education

Abstract

Introduction: Consultant-led ward round education in a busy paediatric setting is a complex process and is often ad hoc. We aimed to observe ward rounds to better understand the education opportunities available.

Methods: Drawing on Argyris and Schön's (1974) theory of action, we used an ethnographic approach to observe 30 general medical ward rounds over a 3-month period, from September to December 2016. For this study we analysed the learning opportunities and the content that is explicitly taught in relation to the domains of professional practice that we espouse to teach.

Results: There were many layers of learning potential observed in ward round practice. These included clinical learning, communication, professional skills and identity and institutional cultural context. Clinical learning was prioritised; however, other learning domains remained implicit and were often ignored.

Discussion: Our findings highlight great complexity in ward round learning and teaching. There was significant missed educational potential in the ward round environment as well as a need for a major shift in educational focus from clinical to other professional domains. Following Argyris and Schön (1974), it is necessary to examine what we espouse against our actual educational practice. This can inform a planned or structured approach to exploit the maximum potential of ward round learning and teaching.

Conclusions: Ward round education is a priority that benefits from observation, reflection and development of new models of practice. If we are not conscious of what we are teaching on rounds, and how this is occurring, we risk losing opportunities to draw on all of the learning potential available.

Author Biographies

Helen Patricia Enright, La Trobe University, Melbourne University of Melbourne Royal Children's Hospital Melbourne

Helen Enright is a Senior Lecturer in Professional Education and Quality Enhancement in the La Trobe Learning and Teaching Unit. Formerly, she was the Learning and Teaching Coordinator at the Department of Paediatrics, the University of Melbourne, the Royal Children's Hospital, Melbourne.

Amy Gray, University of Melbourne Royal Children's Hospital, Melbourne

Dr Amy Gray is the Director of Medical Education, Royal Children's Hospital, Melbourne and a Senior Lecturer, Departmernt of Paediatrics, University of Melbourne

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Published

2020-12-01

How to Cite

Enright, H. P., & Gray, A. (2020). Unpacking the learning on consultant-led ward rounds: Lessons from ethnography in paediatrics. Focus on Health Professional Education: A Multi-Professional Journal, 21(3), 30–43. https://doi.org/10.11157/fohpe.v21i3.336

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