Academic bedside rounding in 10 As: the decalogue technique

Adão, DiegoMartins, Gabriela Caetano LopesZanini, Leonardo Yuri KasputisOliveira, Mateus de AlmeidaCarvalho, Parisina FragaDel Grande, Leonardo de MelloHerbella, Fernando Augusto Mardiros

ABSTRACT Purpose: To propose the 10 As decalogue technique, a structured framework for surgical bedside rounding. Methods: This narrative review and perspective piece presents a descriptive model for bedside rounding, designed for implementation in university hospitals. Literature review was done in MEDLINE via PubMed up to May 2025, using both free terms and Medical Subject Headings related to medical education, clinical rounds, and surgical training. The technique was developed based on clinical and educational principles, addressing both surgical and academic needs. Results: The decalogue consists of the following steps: anticipation, assistant team presentation, authorization, (self)appraisal, assessment, alerts, advice, agreement, annotation, and afterwards. It facilitates comprehensive case discussion, improves trainee clinical skills, and fosters empathy and trust in patient interactions. It addresses time constraints by prioritizing critical cases and enhances learning through debriefing and feedback. Challenges include managing time for multiple patients and ensuring patient comfort during public discussions, mitigated by clear authorization and sensitive communication. Conclusion: The 10 As decalogue is an effective tool for surgical bedside rounding, promoting resident education, reducing errors, and enhancing patient involvement. Its structured approach is particularly suited for academic settings, with adaptability to balance educational and clinical demands.

1. General Surgery
2. Internship and Residency
3. Education, Medical