Implementing patient- and family-centered rounds training with direct-observation assessment for medical students in the United States: a prospective feasibility study.

Abstract

Purpose: This study evaluated the implementation of a patient- and family-centered rounds (PFCR) educational intervention and a standardized assessment form developed to assess changes in medical students' PFCR performance over time.

Methods: From October 2023 to October 2024, medical students at Johns Hopkins School of Medicine attended a 1-hour PFCR simulation workshop during the Core Clerkship in Pediatrics. Students rotating at the main campus were assessed during rounds with a formative standardized form; all students received summative oral presentation and family rapport scores regardless of site. Performance was compared between students rotating in the first half (H1) and second half (H2) of the clerkship using Wilcoxon rank-sum tests with Holm correction for multiple comparisons. Linear mixed-effects models with student-level random intercepts were used to estimate changes across serial assessments.

Results: Among the 74 students rotating at the main campus, assessment forms were completed for 61% of students, with a median of 3 completed forms per student. H1 and H2 students had similar scores on both the formative assessment form and summative evaluations. Both groups improved significantly in inviting patient and family concerns across serial assessments. Summative scores did not differ between students evaluated before and after the educational intervention or between students at the main campus and those at community hospitals.

Conclusion: A structured PFCR educational session paired with a standardized assessment form was feasible to implement in a pediatric clerkship. Observed student-level median scores were at or above "meets expectations" across 6 PFCR domains, and no significant performance decline was observed among students rotating later in the clerkship. Further controlled studies are needed to determine whether this intervention improves PFCR skills compared with usual training.