To test the hypothesis that communication and education during rounds can be improved with a rounding tool, we surveyed general pediatrics residents before and after the implementation of a novel rounding script.

Rounding tools have been used in the general pediatric and intensive care settings to improve communication and standardize the rounding process. In our center as well as other centers, general pediatric residents are responsible for patients on the child neurology service and quality patient care is dependent on good communication. Scant literature exists on the use of a rounding tool to improve communication during neurology rounds.

Additionally, rounds can and should serve to enhance resident education, though this purpose is not always met. We therefore dedicated a section of the rounding script to teaching with the aim of bringing education back to the bedside.

A pre-post intervention study was done by the introduction of a structured rounding script. For each patient encounter, general pediatric residents completed a survey that used Likert scales to assess their perception of communication and education by the neurology attending and resident. A two-sample t-test was conducted with p<0.05 as being statistically significant.  

There were 80 surveys completed in the pre-intervention period and 95 surveys in the post-intervention period. When comparing the Likert score means for satisfaction in communication, there was an improvement between the pre-intervention (mean [M]=3.4, confidence interval [CI]=0.28) and post-intervention (M=4.5, CI=0.25) groups (p<0.001). There was also an improvement in the scores for teaching comparing the pre-intervention (M=3.0, CI=0.27) and post-intervention (M=4.4, CI=0.24) groups (p<0.001).

A rounding script can be used to guide the resident presentations of neurology patients and improve communication between team members. Additionally, by inserting a section specific for teaching within the rounding script, education is brought back to the bedside and is guaranteed with each patient encounter.