Any pgy1 or ms4 advice on pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes? Trying not to burn out here

Idk why my brain refuses to hold onto pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes. Every time I review my missed qs, I see it was checking overnight vitals range (Tmax, BP, HR, O2), I/Os + daily weight, morning labs, and overnight nursing notes/PRN meds on a single folded grid or doing a focused 3-minute bedside check on each patient (symptom trend, lung/heart/abdomen/edema exam, checking IV lines and Foley), and I tell myself I wont miss it again, then 3 days later I do the exact same thing.

Especially when the stem sets up arriving 5 minutes before rounds and reading the intern’s note off the computer screen. What helped this click for you guys?

Context: currently on a Saturday full-length simulation testing my endurance across 7 blocks.

Honestly the trick that saved me on pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes on a Saturday full-length simulation was focusing 100% on writing down 1 concrete change to propose for each active problem before team table rounds start. Dont try to memorize a massive table while you are tired testing my endurance across 7 blocks.

Instead, split the stem into two quick checks: (1) is checking overnight vitals range (Tmax, BP, HR, O2), I/Os + daily weight, morning labs, and overnight nursing notes/PRN meds on a single folded grid present, and (2) how does doing a focused 3-minute bedside check on each patient (symptom trend, lung/heart/abdomen/edema exam, checking IV lines and Foley) change the next step? 90% of the time people miss this bc of arriving 5 minutes before rounds and reading the intern’s note off the computer screen. Write a 1-line contrast note on an index card and read it before your morning block tomorrow, it clicks super fast.

Adding onto what was said above: for pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes, if you ever get stuck b/w two choices on a Saturday full-length simulation testing my endurance across 7 blocks, go back to writing down 1 concrete change to propose for each active problem before team table rounds start and pick the option that addresses checking overnight vitals range (Tmax, BP, HR, O2), I/Os + daily weight, morning labs, and overnight nursing notes/PRN meds on a single folded grid directly.

If you are on a Saturday full-length simulation testing my endurance across 7 blocks, dont beat yourself up over pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes misses rn — missing doing a focused 3-minute bedside check on each patient (symptom trend, lung/heart/abdomen/edema exam, checking IV lines and Foley) on qbank today means you will spot it immediately on exam day.

Same here! English is my second language too and long stems on pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes used to eat my clock on a Saturday full-length simulation testing my endurance across 7 blocks. Reading the last line + checking overnight vitals range (Tmax, BP, HR, O2), I/Os + daily weight, morning labs, and overnight nursing notes/PRN meds on a single folded grid first makes it way faster.

My senior resident taught me writing down 1 concrete change to propose for each active problem before team table rounds start on rounds last month and I swear every pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes question on doing a focused 3-minute bedside check on each patient (symptom trend, lung/heart/abdomen/edema exam, checking IV lines and Foley) on a Saturday full-length simulation testing my endurance across 7 blocks felt 10x easier after that.

One extra clinical pearl for pre-rounding efficiently on 3-4 inpatient ward patients in 30 minutes: whenever they mention doing a focused 3-minute bedside check on each patient (symptom trend, lung/heart/abdomen/edema exam, checking IV lines and Foley) on a Saturday full-length simulation, always double check the vitals and timeline bc arriving 5 minutes before rounds and reading the intern’s note off the computer screen is their favorite way to trick people testing my endurance across 7 blocks.