Abstract
Purpose The aim of the study is to analyze the scope, focus, and educational relevance of
resident grand presentations in relation to the community prevalence and impact of
the diseases discussed.
Design This study is a retrospective review of grand rounds (GR) presentations at Tulane
University School of Medicine's Department of Ophthalmology over a 3-year period.
Methods The topic of each GR presentation between 2009 and 2012 was categorized by subject
matter, prevalence, and impact in a retrospective review of saved PowerPoint files
and surgical videos.
Results Two hundred and eighty-four presentations were analyzed. Retina, glaucoma, cornea
and external disease, and neuro-ophthalmology each comprised approximately one-sixth
(17%) of topics discussed. Cataract and oculoplastics each comprised 9%, with the
remaining cases distributed among other subjects. Sixty-five percent of discussed
diseases were rare, while 19% were uncommon and 15% were common. Seventy-eight percent
of diagnoses had impact on life (30%) or vision (48%). While diseases with minimal
impact were distributed fairly evenly across prevalence categories, 64% of vision-threatening
and 79% of life-threatening diseases were rare.
Conclusions Our cohort of residents spontaneously divided their topics across most subjects within
ophthalmology fairly evenly. Rare diseases comprised a majority of the GR discussions,
so the average GR session did not address diagnoses likely seen in an average clinic.
However, these rare diseases were much more likely to be vision- or life threatening.
Encouraging a greater emphasis on more commonly encountered pathology could improve
GR's daily clinical relevance for resident education, but care must be taken to continue
discussion of rare diseases of critical importance.
Keywords
grand rounds - resident education - clinical relevance
