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Practice corner: Chair’s rounds
  1. Brian Schmitt, MD, MPH1,
  2. Mathew Baugh, MD2,
  3. Steve Scaglione, MD2
  1. 1Hines VA Medical Center
 Hines, Illinois, USA
  2. 2Loyola University Medical Center
 Maywood, Illinois, USA

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    For many training programmes, a weekly Chair’s Rounds is an opportunity for residents to present challenging cases to the Chief of Medicine with the hope of identifying new diagnostic and/or therapeutic insights for the management of a given patient. The quality of this free-form discussion (sometimes a “free-for-all”) generally reflects the depth of knowledge and experience of the Chair with the patient’s clinical situation. However, recommendations and opinions may not reflect the best (or current) evidence for guiding real life decisions at hand. We revised the format of our Chair’s Rounds 3 years ago to improve medical decision making directed toward specific patients while simultaneously teaching principles of evidence-based medicine (EBM).1

    CHAIR’S ROUNDS

    Our goal was to integrate the tools and methods of EBM into the care of specific patients.1 We focused on improving residents’ understanding of the quantitative measures of medicine, formulating appropriate clinical questions, conducting a literature search to answer the question, and learning clinical epidemiological guidelines for critically assessing the selected literature. Residents’ case presentations and diagnostic reasoning remain key elements of the Rounds, but we reorganised the time to achieve the above objectives. Weekly Chair’s Rounds are 75 minutes long and focus on 3 separate activities: the “statistical hot seat,” critical appraisal of a specific case-related article, and new case presentations with question formulation.

    THE STATISTICAL HOT SEAT

    Each week, a clinical problem is circulated to all residents and students on medical service 2 days before Rounds. The clinical problem is derived from previous cases and focuses on data interpretation skills. …

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