Background: For many inpatient wards teams, morning rounds remain the primary time many attendings use to engage learners in clinical decision making and education. Literature supports the use of bedside rounds to improve learner communication and patient engagement. However, many institutional, learner, and patient factors may impact attending choice in how they round with learners.
Methods: We sought to explore the current experiences of academic hospitalists using common rounding styles, hospitalist perception of different rounding styles, and challenges that exist in implementation. Five semi‐structured virtual focus groups were held with 35 unique individuals from 25 different organizations. Participants were part of the Hospital Medicine Reengineering (HOMERuN) Research Network. Rapid qualitative methods including templated summaries and matrix analysis were applied. A brief 10‐question survey was also conducted.
Results: Five semi‐structured virtual focus groups were held with 35 individuals from 25 different organizations on June 13th 2025. Twenty-seven participants completed the survey (77% response rate). Mean years of practice was 9 with a standard deviation(SD) of 3.6. Twenty participants (74%) had more than twelve weeks of clinical service each year and on average, participants rotated with learners on traditional rounding services for 8 weeks out of the year (SD 3.77). Of those who filled out the survey, 25 participants practiced at a University Hospital (92.6%), one practiced at a community hospital (3.7%), and one practiced at a Veterans Affairs Hospital (3.7%). Thirteen participants (48%) did not engage in bedside rounds at all and twenty two participants (81.5%) did so less than 25% of the time. Only two participants (7%) used bedside rounds more than 50% of the time. Fourteen participants (52%) used hallway rounds 50% of the time or more and twelve participants (44%) used card flipping rounds 50% of the time or more. Across all survey participants, bedside rounds were used 12% of the time, hallway rounds were used 49% of the time, and card flipping rounds were used 39% of the time. All (100%) survey participants utilized hallway rounds to some degree.Preliminary findings indicate that hospitalists emphasize the value of bedside or hallway rounds in learner education and enhancing clinical care. However, hospitalist, learner, and patient preferences do not always align. Additionally, multiple systemic barriers impact rounding choices leading hospitalists to navigate the tension between educational value and efficiency.
Conclusions: In this multicenter qualitative study of academic hospitalists, we found that rounding practices remain highly variable, with most hospitalists using hallway and card-flipping rounds more often than bedside rounds. Despite recognition of benefits of bedside rounding across focus groups, participants described significant system and individual-level barriers that limit its use. Participants highlighted misalignment between learner, attending, and patient preferences that shape rounding choices. We will complete full thematic analysis of focus groups to advance prior survey-based work by providing a deeper understanding of how hospitalists navigate tensions between educational value and system efficiency. Beyond this, we hope to explore resident perspectives in future work and utilize these perspectives to target interventions.