Introduction: ICU rounds in teaching hospitals focus on the management of multisystem patient problems, generating discussions about physiology, diagnosis, therapy, prevention and palliation. The objective of this study was to examine the utilization and attitudes about a recently introduced daily goals checklist (DGC) in a university-affiliated ICU from the perspective of residents. Hypothesis: We hypothesized that ICU residents would use the DGC as a tool to enhance patient care and to stimulate their education. Methods: This was a mixed-methods study. Two investigators conducted field observations to understand how, when and by whom the DGC was used on 80 ICU patient rounds over 6 days. To minimize the Hawthorne effect, ICU clinicians were blinded to the purpose of the resident observer on rounds. Second, we conducted individual semi-structured interviews and focus groups of 14 rotating residents regarding the use of the DGC. These were audio-taped, transcribed and analyzed inductively to identify emerging themes. Triangulation was achieved through 2 data sources, 2 qualitative research methods and a multidisciplinary investigative team. Results: During 80 patient rounds, the DGC was used for 93% of patients, completed by a resident (86% of patients), then verbally reviewed and championed by a resident (83% of patients). It served as a tool engaging bedside clinicians in detailed, individualized care plans. Residents endorsed the utility of the DGC foremost to (1) ensure a systematic comprehensive care plan that minimized errors of omission and commission; (2) serve as a communication aid primarily with nurses; and (3) provide a touchstone for learning evidence based practices. The DGC was considered least helpful to guide weaning and rehabilitation, and to understand complex psychosocial issues. Conclusions: In this university-affiliated ICU, residents were heavily involved in the utilization and completion of the DGC. The checklist was considered by residents to be a multipurpose tool - to facilitate their role on rounds to optimize patient care, further inter-professional communication, enhance patient safety, and prompt teaching opportunities.