“Medicine is learned by the bedsideand not in the classroom.”
Sir William Osler
Crumlish CM, et al. Quantification of Bedside Teaching by an Academic Hospitalist Group. J Hospital Medicine 2009; 4:304-7.
82%
of residents want MORE
94%
“bedside teaching timeis valuable”
Bedside Teaching
Sameer D. Khatri, M.D.
Faculty Development Fellow
Take home points
• Everyone has something to offer
• Make a road map
• Stay attentive and be flexible
Learning objectives
• List obstacles to bedside teaching
• Identify advantages
• Try out models for bedside teaching
• Discuss ways to overcome obstacles
• Plan integrating into rounds
Who learns on rounds?Read 10%
Hear 20%
See 30%
See & Hear 50%
Say & Write 70%
Do 90%
Dale, E. Audiovisual Methods in Teaching, 1969, NY: Dryden
So what’s stopping us???
•List obstacles to performing bedside rounds
Barriers from the survey
• Lack of time / not efficient use of time
• More effort – have to get up and move
• Difficult to fully prepare
• Patient discomfort
• Availability of patients
•Describe the advantagesto bedside rounds
What do people value about clinical bedside teaching?• See/teach PE skills
and provide immediate feedback
• Demonstrate professionalism / teach art of medicine
• Get patients involved
• Clarify patient issues
• Pt-centered care
• PE teaching
• Interpersonal skills
• Communication skills
• Integrating clinical exam w/ dx & mgmt decisions
Crumlish CM, et al. 2009MAMC FM, 2012
How can we do it?
• Follow a 12-step model
• Follow a 3-domain model
• Make up our own model
Road maps and focused teaching
• Pick one model
• Pick a real case
• Work through the steps
Take 15 minutes
Overcoming obstacles
• Lack of time / not efficient use of time
• More effort – have to get up and move
• Difficult to fully prepare
• Patient discomfort
• Availability of patients
Overcoming obstacles
• Lack of time / not efficient use of time
• Structured time
• Targeted learning points
• More effort – have to get up and move
• Difficult to fully prepare
• Patient discomfort
• Availability of patients
Overcoming obstacles
• Lack of time / not efficient use of time
• More effort – have to get up and move!
• Make it a part of your everyday routine
• Worth the effort
• Difficult to fully prepare
• Patient discomfort
• Availability of patients
Overcoming obstacles
• Lack of time / not efficient use of time
• More effort – have to get up and move
• Difficult to fully prepare
• Focus on key learning points
• Brush up on skills likely to be covered
• Patient discomfort
• Availability of patients
Overcoming obstacles
• Lack of time / not efficient use of time
• More effort – have to get up and move
• Difficult to fully prepare
• Patient discomfort
• Ask for permission in advance
• Team introduction / get patient involved
• Availability of patients
Overcoming obstacles
• Lack of time / not efficient use of time
• More effort – have to get up and move
• Difficult to fully prepare
• Patient discomfort
• Availability of patients
• Be flexible
Strategies to increaseBedside Teaching
See handout
Taking it to the Ward
What can we commit to now?
Learning objectives
• Listed obstacles to bedside teaching
• Identified advantages
• Tried out models for bedside teaching
• Found ways to overcome obstacles
• Planned integration into rounds
Take home points
• Everyone has something to offer
• Make a road map and follow it
• Stay attentive and flexible
Questions&
Comments