The use of a ward round teaching tool in a paediatric oncology department


Dr Trisha Soosay Raj (CHQ Clinical Unit, Queensland Children's Hospital)

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A/Prof Amy Gray, University of Melbourne, Melbourne, Australia; Department of Paediatrics, Royal Children’s Hospital, Melbourne, Australia
Prof Geoff McColl, University of Queensland, Brisbane, Australia

Purpose: Despite ward rounds being fundamental to hospital-based clinical training, the reported educational value is low. This is exacerbated in busy environments, with missed learning opportunities due to implicit learning, time barriers and lack of ward round structure. The STIC framework (Set, Target, Inspect and Close) provides a learner-centred, structured approach to ward round teaching, aimed to enhance education within limited timeframes.

We aimed to investigate how the introduction of the STIC framework impacts on learner-centred teaching within the Paediatric Oncology department of a tertiary hospital.

Methods: A mixed-methods approach was used to evaluate implementation of the tool, with two participant groups comprising 16 junior and senior doctors over three months. Surveys were used to document junior staff experience on rounds pre- and post-implementation, with focus groups and interviews used for all participants to explore satisfaction and attitudes to the tool.

Results: There was improved learner satisfaction across all domains of the framework, specifically opportunities for leading clinical encounters and learning on consultant-led rounds. Despite consultants reporting lack of uptake of the tool, trainees reported improved teaching. Consultant beliefs and enthusiasm had a strong impact on trainee satisfaction, influencing team culture. Trainees placed high value on active participation and autonomy for their learning. Factors distinct to teaching were reported to affect learner satisfaction, such as planning, time management and departmental culture including being part of the team and safety to ask questions.

Conclusion: We demonstrate enhanced teaching despite poor perceived uptake, demonstrating potential of the STIC framework with further implementation. Our study also highlights that in addition to a specific teaching focus, consultant engagement and a safe clinical learning environment are crucial for learning.

Practical importance: As ward round as recognised as a key entrustable professional activity for trainee doctors, findings from this study could be utilised more broadly in the hospital setting to improve daily learning in the clinical environment.

Ethics ref.LNR/20/QCHQ/61830 (QCH HREC)

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