“Medicine is learned by the bedside and 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: % of residents want MORE 94 % “bedside teaching time is 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 advantages to 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 increase Bedside 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