Background: Attending teaching rounds are central to inpatient education and patient care, yet competing demands shape how they are conducted. We examined how attending physician rounding style preferences align with actual utilization across internal medicine teaching services and identified patient-, team-, and institution-related factors influencing these choices.
Methods: We conducted an IRB-approved, cross-sectional mixed-methods survey of attending physicians supervising general medicine inpatient teaching services at three internal medicine residency programs. Eligible attending physicians (n=114) received an online survey. Quantitative analyses used descriptive statistics and Fisher’s exact tests; qualitative responses underwent thematic coding.
Results: Fifty-two attending physicians responded (46% overall). In the ideal scenario, rounding style preferences did not differ by gender, race/ethnicity, number of institutions worked, or clinical time (p>0.05). Years in practice and at the current institution influenced preferred rounding style for new admissions (< 7 vs. >16 years; p< 0.025 and p=0.018): less-experienced attending physicians favored hallway, more-experienced attending physicians favored bedside. Overall, bedside was preferred for new admissions (40%), while conference room was preferred for follow-up patients (65%). Rounding style utilization differed from preferences. Overnight admissions varied by gender (p=0.023), residency affiliation (p=0.040), years in practice (p=0.0016), and years at institution (p=0.027). Higher census favored hallway (p=0.046), while primary language (p=0.043) and medical education commitments (p=0.0063) were associated with bedside. Daytime admissions differed by residency affiliation (p=0.0067). Follow-up patients varied by residency affiliation (p=0.040) and was associated with interprofessional availability (p=0.018) and institutional norms (p=0.032), both favoring conference room rounding; medical education commitments also favored conference room rounding (p=0.0003). Despite perceiving that learners prefer conference room (88%), attending physicians rated bedside as best for learner evaluation (77% students; 79% residents) and patient-centeredness (80%). Qualitative themes emphasized hybrid models to balance efficiency, psychological safety, direct observation, and patient engagement.
Conclusions: Attending rounding style is not “one-size-fits-all.” Preferences favor bedside for patient engagement and learner assessment, but utilization is shaped by census, staffing, institutional norms, and culture. Intentional, hybrid rounding workflows tailored to patient needs and team dynamics align educational value with patient-centered care. Faculty development should emphasize strategies to see patients as a team regardless of style. Future studies should assess the impact of specific hybrid models on learner and patient outcomes.