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04.17 - Debrief of Bedside Rounds

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04.17 - Debrief of Bedside Rounds

The objectives for this module are that after you actively engage in the activities, you will be able to: 1. Describe the factors affecting autonomy 2. Be prepared to navigate the barriers to entrustment 3. Understand how to appropriately facilitate resident autonomy and grant trainee suitable entrustment of patient care to enhance education.

The purpose of this course is to improve feedback, clinical teaching, and assessment of clinical skills.

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Enseigné par

Sally Santen, M.D., Ph.D.
Associate Professor - Emergency Medicine

Transcription

So, it's good to see that in a different setting.

Mm-hm. In terms of how do rounds look like and

how do you take care of patients kind of as a team on rounds.

What did you think about that one?

>> Yeah, it was interesting to see that, the different scenario

It was almost comical when Emily and

Melissa at the very same moment started to talk to the patient.

Emily clearly thought that she should be the one leading the discussion.

Whereas Melissa, the first brand new attending on the service,

she doesn't know anything about the patient,

thinks that she should be the one having that interaction with the patient.

It didn't really allow Emily to have any ownership of the patient even though she

probably could have told Mose everything.

>> Yeah, exactly.

She's kind of stepped right over her.

>> Yes. >> [LAUGH] It was funny, yeah.

>> Yeah.

>> And it really didn't give the patient a chance to kind of have trust in her

team in some ways?

>> No, it didn't the way Melissa handled that made it seem to the patient like she

didn't even trust the history she'd taken.

Because Melissa said to her, so I understand that you're here for

chest pain or whatever and let the patient then give her more history.

>> Mm-hm.

>> When clearly Emily could have at least done that much.

>> Yeah. >> And

then Melissa dictated kind of what the plan was going to be.

>> Yeah. >> Even though

I'm sure Emily already had that.

>> Yeah. >> All that ready.

>> Yeah. >> And it was clearly the I'm the boss

without even having to say I was the boss.

>> [LAUGH] Yes definitely.

>> So, I think it's important not to do that, right?

>> Yeah. >> I mean you need to let them have

the authority and the responsibility and the autonomy that they need.

>> Yeah.

>> And only step in if there's a problem.

>> Right, that completely changed the dynamics of that group.

Instead of Emily being the leader and being the one, sort of running the show.

All of a sudden the focus went to Melissa, and everybody,

the whole team was looking at Melissa.

>> Yeah, yeah.

It's a shame.

>> Yeah.

>> All right, Let's watch another clip, okay?

>> Right.

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