Ward rounds as a patient-centred pedagogical device

Abstract

Introduction: Ward rounds remain central to hospital care and clinical training. They bring together patient care, team coordination, diagnostic and therapeutic deliberation, and a substantial part of students’ and residents’ everyday learning. Despite this centrality, their pedagogical status remains underdeveloped and patients are often portrayed more as the context of learning than as constitutive subjects of the educational device.

Objective: To integrate the literature on ward rounds, bedside rounds, workplace learning, person-centred clinical communication, health literacy, questioning techniques, verbalization of expert reasoning, competency-based medical education, and entrustable professional activities, in order to propose a reconceptualization of ward rounds as a patient-centred pedagogical device.

Method: A conceptual narrative review was conducted, drawing on empirical studies, systematic reviews, AMEE guides, and foundational papers in the field. The synthesis was organized thematically and interpretively.

Results: The educational value of ward rounds depends on the quality of participation, the visibility of clinical reasoning, the deliberate use of questioning, the organization of the care environment, and the inclusion of the patient as both a clinical interlocutor and a recipient of health education. Based on this integration, a model is proposed with four interdependent dimensions - clinical, pedagogical, relational, and evaluative - organized around a transversal axis of patient centrality and health education.

Conclusions: This perspective positions ward rounds as a privileged setting for situated learning, progressive autonomy, observation of complex professional activities, and development of health professionals’ educational competence. Under this view, rounds should be designed more intentionally as a practice that integrates care, team learning, and patient education.