This is the podcast ICRounds, the podcast that's been focused really on for years on the teaching of surgical critical care in the intensive care unit.

And one of the topics that we've never really covered, but is a source of a lot of anxiety and concern for the starting medical student or the intern, is the process of pre-rounding and presenting

on rounds. Your goal is to help the team understand the patient quickly, accurately, and safely.

Every medical student eventually experiences this moment. You stayed up late reading about a disease,

memorized the entire differential diagnosis,

then on rounds, the intending starts to ask a question.

How much urine came out overnight?

And suddenly you realize rounds are different than what you expect.

Rounds are about prioritization,

rounds are about operational awareness that matters, and rounds

are about concise communication that matters.

To be ready for rounds, one needs to be doing pre-rounds.

Pre-rounding is not just collecting random facts.

It's really answering four specific questions.

Is the patient better, worse, or unchanged? To perform well on

rounds, one has to pre-round, one has to do the preparation. And pre- rounds is not just

collecting random facts. Pre-rounds are very deliberate and it's really about

answering four key questions. Is the patient better,

worse, or unchanged overnight? Is the patient physiologically stable? What problems need

action today? And the fourth question is what barriers prevent discharge or progression

of the patient? These four questions are helpful because, in my opinion, surgeons think

and these are four of the top priorities when you go to assess a patient first thing in the

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