Key Takeaways
- Ward round communication should be concise, organised and clinically relevant.
- Prepare before presenting a patient and identify the most important changes.
- Senior doctors usually expect a clear summary rather than the entire medical history.
- Listen carefully to the agreed plan and clarify anything that is uncertain.
- Communicate respectfully with patients and other members of the multidisciplinary team.
Introduction
Ward rounds can be challenging for International Medical Graduates, particularly when they are unfamiliar with the local hospital culture.
The pace may be fast, senior doctors may ask unexpected questions, and important decisions may be made within a few minutes. Even doctors with strong medical knowledge can find it difficult to decide what information to present and how much detail to include.
Expectations vary between hospitals, specialties and individual consultants. However, effective ward round communication generally involves preparation, concise presentation, active listening and clear confirmation of the plan.
Here are seven communication skills that can help IMGs contribute more confidently during ward rounds.
1. Prepare Before the Ward Round Begins
Good ward round communication starts before the team reaches the patient.
Review the available information and identify:
- Why the patient was admitted
- The main diagnosis or current clinical problem
- Important events since the previous review
- Changes in observations or symptoms
- Relevant test results
- Current treatment
- Outstanding tasks or decisions
You do not need to memorise every detail. The aim is to understand the patient’s current position and locate important information quickly if asked.
If you are unsure about a result or event, say so honestly:
“I haven’t been able to confirm that result yet, but I’ll check it immediately after the ward round.”
This is safer and more professional than guessing.
2. Begin with a Clear Clinical Summary
Senior doctors usually need a brief overview before discussing individual details.
A useful opening might be:
“Mrs Khan is a 72-year-old woman admitted three days ago with community-acquired pneumonia. She is receiving intravenous antibiotics and oxygen. Overnight, she remained stable, and her oxygen requirement has decreased.”
This tells the team:
- Who the patient is
- Why they are in hospital
- What treatment they are receiving
- What has changed
Avoid starting with every detail from the original admission unless it remains relevant.
For example, instead of giving a long chronological history, you might say:
“The main issue today is that her fever has returned despite 48 hours of antibiotics.”
This helps the team focus on the current clinical question.
3. Prioritise New and Relevant Information
A common mistake is presenting too much information because everything feels important.
Senior doctors are generally most interested in what has changed since the last review:
- New symptoms
- Deterioration or improvement
- Abnormal observations
- Important investigation results
- Response to treatment
- New concerns from the patient or nursing team
- Barriers to discharge
Useful phrases include:
- “Since yesterday, the main change is…”
- “The most recent blood results show…”
- “The patient’s main concern this morning is…”
- “The outstanding issue is…”
- “She is medically improving, but discharge is delayed because…”
Prioritising does not mean hiding information. It means presenting the most clinically relevant details first and providing further information when requested.
4. Use a Consistent Structure
When you are nervous, it is easy to jump between different parts of the history. A consistent structure makes your presentation easier to follow.
Depending on the situation, you might include:
- Patient identification
- Reason for admission
- Current diagnosis or working diagnosis
- Important events since the previous review
- Current clinical condition
- Relevant results
- Current treatment
- Main question or required decision
For urgent concerns, a structure such as SBAR can be useful:
- Situation: What is happening now?
- Background: What does the listener need to know?
- Assessment: What do you think the problem is?
- Recommendation: What action or review do you need?
For example:
“I’m concerned that Mr Jones may be deteriorating. He was admitted with pneumonia and has become increasingly breathless over the last hour. His oxygen saturation is now 88% despite oxygen. I think he needs an urgent senior review.”
The structure helps you communicate the urgency clearly.
5. Answer Questions Directly
Senior doctors may ask short, specific questions during the ward round.
If you know the answer, give it clearly:
“His temperature was 38.2 degrees at 6 a.m.”
If you need to check:
“I don’t have the exact value with me, but I’ll check it now.”
If you do not understand the question, ask for clarification:
“Sorry, are you asking about her usual medication or what she has received since admission?”
Avoid giving a long, indirect answer when a brief response is required. You can add relevant context afterwards if necessary:
“Her creatinine is 145, up from 110 yesterday.”
This is clearer than beginning with a detailed explanation before stating the result.
6. Communicate with the Patient, Not Only the Team
A ward round can easily become a conversation between healthcare professionals while the patient listens without understanding.
Introduce members of the team when appropriate and explain the purpose of the review:
“Good morning, Mr Ali. We’re the medical team looking after you. We’d like to see how you’ve been overnight and discuss today’s plan.”
Avoid discussing the patient as though they are not present.
Use plain English when explaining decisions:
“The blood tests show that the infection is improving, but we’d like to continue the antibiotics through the drip for another day.”
Invite the patient to contribute:
- “How have you been feeling since yesterday?”
- “Is there anything you’re particularly worried about today?”
- “What questions do you have about the plan?”
Even during a busy ward round, a brief explanation can help the patient feel informed and respected.
7. Confirm the Plan and Your Responsibilities
Ward round plans often involve several people and multiple tasks. Misunderstandings can occur if responsibilities are not made clear.
At the end of the discussion, summarise the plan when appropriate:
“Just to confirm, we’ll repeat the blood tests today, change to oral antibiotics and ask physiotherapy to review her mobility.”
If you have been assigned a task, confirm it:
“I’ll arrange the chest X-ray and review the result this afternoon.”
If the instruction is unclear, ask before the team moves on:
“Would you like the scan requested urgently today, or as a routine investigation?”
Writing down tasks can help, but make sure you understand them rather than recording words without clarification.
After the ward round, review the task list, identify urgent actions and communicate any important changes to the relevant team members.
Common Ward Round Phrases
Presenting a patient
- “The main issue today is…”
- “Since yesterday, the patient has…”
- “The latest results show…”
- “The patient is clinically improving, although…”
- “The outstanding concern is…”
Asking for clarification
- “Could I clarify the plan for the antibiotics?”
- “Would you like that arranged today?”
- “Just to confirm, should we repeat the blood test tomorrow?”
- “Who will be responsible for following up the result?”
Raising a concern
- “I’m concerned about the patient’s increasing oxygen requirement.”
- “The nursing team has noticed that she has become more confused.”
- “I think we may need to review the discharge plan.”
- “Could we discuss whether a senior review is needed?”
These phrases are simple, but they help you communicate clearly and professionally under pressure.
Final Thoughts
Effective ward round communication is not about speaking for the longest time or demonstrating everything you know.
Senior doctors generally need concise, relevant information that helps the team assess the patient and make safe decisions. Patients also need clear explanations and an opportunity to raise concerns.
Prepare beforehand, identify what has changed and use a consistent structure. If you do not know something, say so and check it. If the plan is unclear, ask for clarification before acting.
With regular practice, ward round presentations can become more focused, natural and confident.
Book a consultation to discuss your goals and see how I can help.