Round34: Attending-Moderated Tabletop Gameplay to Enhance Resident Team Dynamics During Inpatient Rounds

Background: Inpatient medical rounds are central to experiential learning in residency education but are often challenged by high team turnover and hierarchal dynamics, limiting team engagement, comfort in asking questions, and education. Gamification can address these challenges. Objective: To evaluate the impact of Round34, an investigator-developed cooperative card game designed to improve health care team dynamics on residents' engagement in rounds, comfort in asking questions, and perceived educational value of rounds. Methods: In a 22-week prospective randomized trial at a single academic center in 2024, paired inpatient internal medicine teams were randomized to intervention (game) or control (standard rounds) groups. Round34, played during teaching rounds, included prompts ranging from humor to clinical questions to facilitate interaction. Residents completed daily 10-point Likert surveys on perceived educational value of rounds, engagement, and comfort in asking questions (primary outcomes). Weekly surveys measured secondary outcomes of burnout (Maslach Burnout Inventory), well-being (Resident & Fellow Well-Being Index), and loneliness (UCLA Loneliness Scale). Rounding time was recorded daily. Outcomes were analyzed with ordinal regression adjusted for patient volume (total/new), call days, and round duration. Results: