Table 4.
Program director survey responses: structure and perceptions of hospital nephrology rounds
| Parameter | All, n=55 | Domain/Subdomain | |
|---|---|---|---|
| Do faculty have concurrent clinical or administrative responsibility? | Domain: structure subdomain: workload | ||
| No | 4 (7%) | ||
| Yes | 51 (93%) | ||
| It is acceptable for fellows to collect patients’ data without examining the patients before rounding with the attending? | Domain: perception subdomain: perceived value | ||
| Strongly disagree | 9 (16%) | ||
| Disagree | 15 (27%) | ||
| Neither agree or disagree | 4 (7%) | ||
| Agree | 20 (36%) | ||
| Strongly agree | 7 (13%) | ||
| Do you expect your fellows to preround? | Domain: structure subdomain: workflow | ||
| No | 2 (4%) | ||
| Yes, but only to collect data, not to examine | 14 (25%) | ||
| Yes, both to collect data and to examine | 39 (71%) | ||
| When do you typically finish cosigning all fellows progress notes during a day shift on the inpatient consult service? | Domain: structure subdomain: workflow | ||
| 11 am to noon | 2 (4%) | ||
| Noon to 5 pm | 10 (18%) | ||
| 5 pm to 8 pm | 23 (42%) | ||
| After 8 pm | 20 (36%) | ||
| Type of technology during rounds on the inpatient consult servicea | Domain: structure subdomain: workflow | ||
| Electronic tablets | 18 (33%) | ||
| Mobile phone applications to view patient data | 36 (65%) | ||
| Laptops | 23 (42%) | ||
| Voice-recognition software to dictate patient progress notes | 15 (27%) | ||
| Number of technologies used | Domain: structure subdomain: workflow | ||
| 0 | 7 (13%) | ||
| 1 | 21 (38%) | ||
| 2 | 12 (22%) | ||
| 3 | 13 (24%) | ||
| 4 | 2 (4%) | ||
| Missing | 0 (0%) | ||
| Which do you consider the most valuable for building fellows’ clinical skills?b | Domain: perception subdomain: perceived value | ||
| Analyzing laboratory results | 15 (27%) | ||
| Formulating a differential diagnosis and management plan by writing consults and progress notes | 9 (16%) | ||
| Bedside discussion of differential diagnosis and management plan with attending | 24 (44%) | ||
| Remote discussion of differential diagnosis and management plans with attending | 5 (9%) | ||
| Which do you consider the most significant barrier to efficient rounds?b | Domain: perception subdomain: perceived efficiency | ||
| Electronic medical records | 15 (27%) | ||
| Trainee duty hours | 1 (2%) | ||
| Fellows unprepared for the clinical demands of nephrology fellowship | 17 (31%) | ||
| Competing clinical and administrative responsibility for faculty | 15 (27%) | ||
| Competing clinical responsibility for fellows | 6 (11%) | ||
| Patient care is improved when fellows interview and examine patients before rounding with the attending. | Domain: perception subdomain: perceived value | ||
| Strongly disagree | 3 (5%) | ||
| Disagree | 2 (4%) | ||
| Neither agree or disagree | 11 (20%) | ||
| Agree | 20 (36%) | ||
| Strongly agree | 19 (35%) | ||
| Fellows’ clinical skills improve when they interview and examine patients before rounding with the attending. | Domain: perception subdomain: perceived value | ||
| Disagree | 2 (4%) | ||
| Neither agree or disagree | 7 (13%) | ||
| Agree | 22 (40%) | ||
| Strongly agree | 24 (44%) | ||
| Patient care is improved when fellows and attendings interview and examine patients together. | Domain: perception subdomain: perceived value | ||
| Strongly disagree | 3 (5%) | ||
| Disagree | 8 (15%) | ||
| Neither agree or disagree | 16 (29%) | ||
| Agree | 18 (33%) | ||
| Strongly agree | 10 (18%) | ||
| How efficient are your clinical rounds on the inpatient consult services? | Domain: perception subdomain: perceived efficiency | ||
| Not efficient | 2 (4%) | ||
| Rarely efficient | 2 (4%) | ||
| Somewhat efficient | 23 (42%) | ||
| Efficient | 23 (42%) | ||
| Very efficient | 4 (7%) | ||
a
The responses for these questions are not mutually exclusive and the percent may not add to 100.
b
The responder ranked the preidentified options for these questions.