Orthopedic grand rounds can change resident practice. 2013

Robert V Cantu, and Marcus P Coe, and David M Pober, and Ira R Byock
Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03755, USA. robert.v.cantu@hitchcock.org

This study sought to determine whether a grand rounds presentation could change resident practice. A 6-month review of all hip fracture patients 65 years and older at a single academic medical center was performed. The rate of addressing advanced directives and code status as documented in the medical record was noted. A grand rounds presentation was then given to the orthopedic department, and the medical records of hip fracture patients for the 12 months following the grand rounds were reviewed. In the 6 months prior to the grand rounds, orthopedic residents did not document code status or advanced directives in any of their admission or consultation notes. Following the grand rounds, orthopedic residents addressed advanced directives, code status, and contact person in 76% of their admission notes. There was a marked difference in the rate of documentation among residents who attended the grand rounds (88%), compared with residents who did not attend grand rounds (20%). Based on the results of this study, specifically whether residents attended grand rounds, this form of teaching can lead to changes in resident behavior.

UI MeSH Term Description Entries
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D008297 Male Males
D009985 Orthopedics A specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.
D010820 Physicians Individuals licensed to practice medicine. Physician
D005260 Female Females
D006620 Hip Fractures Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES). Femoral Trochlear Fractures,Intertrochanteric Fractures,Subtrochanteric Fractures,Trochanteric Fractures,Trochlear Fractures, Femur,Femoral Trochlear Fracture,Femur Trochlear Fracture,Femur Trochlear Fractures,Fracture, Femoral Trochlear,Fracture, Femur Trochlear,Fractures, Femoral Trochlear,Fractures, Femur Trochlear,Fractures, Hip,Fractures, Intertrochanteric,Fractures, Subtrochanteric,Fractures, Trochanteric,Trochlear Fracture, Femoral,Trochlear Fracture, Femur,Trochlear Fractures, Femoral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001291 Attitude of Health Personnel Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc. Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes

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