Educational Opportunities and Barriers to Learning During Post-Take Ward Rounds. A Systematic Review.

Background: Bedside teaching is essential to medical education and is considered an effective method for teaching technical and nontechnical skills. The post take ward round (PTWR) is often the first review of patients’ presentations, diagnoses, and management plans and serves as a teaching forum. Although PTWRs are vital in inpatient care, their educational values remained under-researched. This review aims to identify educational opportunities and barriers to learning during PTWRs. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted in bibliographic databases, PubMed, Medline, the Cochrane Library, Scopus Web of Science, the Cumulative Index to the Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, and Google Scholar, and 14 articles were identified and appraised by the Medical Education Research Study Quality Instrument (MERSQI). A modified Kirkpatrick's framework was used to guide data extraction. Themes about learning were identified, integrated, and presented in evidence tables. Results: The highest and lowest MERSQI scores for individual studies were 13.5 and 6.5, respectively. The MERSQI mean score for the included studies was 10.08 (SD 1.82). Thirteen studies (92.8%) reported Kirkpatrick’s level 1(Reactions), 12 (85.7%) reported level 2 (knowledge, skill, and attitude), 7 (50%) reported level 3 (Behaviour), and only 2 (14.2%) reported level 4 (outcomes). Clerking and presentation, using pre- and post-round times for discussions, questioning, demonstration, and active participation, were perceived as educational opportunities. However, time pressures, workload, a lack of feedback, and inadequate preparation and engagement are barriers to learning. Conclusion: PTWRs are opportunities to learn nontechnical skills. They improve knowledge and skills related to diagnostic tests and care escalation. Learning during PTWRs requires preparation, engagement, attention to active participation, a feedback culture, role modelling, and team structure.