338 - Trainee Perspectives on the Learning Environment and Provision of Teaching During Pediatric Bedside Rounds

Publication Number: 4331.338

Nina Gupta, Phoenix Children's Hospital, Phoenix, AZ, United States; Nehal Thakkar, Phoenix Children's Hospital, Phoenix, AZ, United States; Anna Kushnir, Phoenix Children's Hospital, Phoenix, AZ, United States; Sandra Gage, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, United States; Reina Patel, Phoenix Children's Hospital, Phoenix, AZ, United States; Lisa J.. Fox, Phoenix Children's Hospital, Phoenix, AZ, United States; Lucia Mirea, Phoenix Children's, Scottsdale, AZ, United States

Background: Teaching during rounds is a key component of medical education. While peer observation studies have examined bedside teaching from the attending perspective, limited literature exists on resident viewpoints. Family-centered rounds (FCR) studies have identified the attending as a key factor in resident satisfaction, yet the specific ways in which attendings impact trainee education during rounds remains understudied.

Objective: This study explores trainee perceptions of bedside teaching and the learning environment during rounds to identify attending-specific factors that influence educational experiences.

Design/Methods: This prospective cohort study was conducted at a tertiary children's hospital from April to August 2025. Twenty inpatient rounds led by 16 hospitalists and with 59 participating residents were observed. Four senior residents and one hospital medicine fellow served as observers and completed observation forms. The fellow's independent observations served as a consistent control across all observations. Participating residents completed post-rounds surveys assessing resident comfort engaging in discussion, level of resident autonomy, and attending teaching style. Likert-scale items (1= strongly disagree, 5= strongly agree) were summarized descriptively. Free-text responses underwent thematic analysis with independent coding and consensus reconciliation.

Results: A total of 39 observation forms were completed by observers. Forty-four post-rounds surveys were completed by participating residents (PGY-1: 61%, PGY-2: 16%, PGY-3: 23%). On a 5-point scale, participating residents reported a mean score of 4.49 for comfort engaging in questions, compared with 4.63 from observing residents and 4.95 from the fellow (p = 0.07). For attending support of autonomy, participating residents reported 4.49, compared with 4.68 and 4.95, respectively (p = 0.03). Thematic analysis revealed six themes: communication, learning environment, autonomy, teaching methods/ techniques, barriers to education, and time management (Table 1).

Conclusion(s): Attending physician behaviors and demeanor strongly influence the bedside learning environment. Observers perceived greater comfort and autonomy than participating residents, suggesting that clinical experience and observer role may affect perceptions of teaching. Clear communication, structured teaching, and protected time enhanced learning, while competing demands and variable autonomy hindered it. These findings highlight opportunities to strengthen resident engagement and maximize educational value during bedside rounds.

Table 1: Thematic Analysis of Trainee Perspectives on Bedside Rounds
Responses from all four survey questions were coded using a shared codebook, and the same themes and sub-themes were applied across questions; however, not all sub-themes were represented in each question's responses. Letters next to each sub-theme denote which question(s) generated quotes coded under that sub-theme. Key: Q1 = Factors influencing how comfortable the attending made residents feel asking and answering questions, Q2 = Factors influencing how well the attending supported resident autonomy, S = Strengths of attending's bedside teaching approach, R = Recommendations for attending physicians to improve bedside teaching.