Bedside Teaching in Neurology

Dewey, Jeffrey; Cho, Tracey A.

doi:10.1055/s-0038-1666984

Semin Neurol

2018

DOI: 10.1055/s-0038-1666984

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Bedside Teaching in Neurology

Jeffrey Dewey

Tracey A. Cho

Abstract: The patient's bedside offers an ideal venue for teaching the art of clinical neurology and modeling humanism and professionalism. However, bedside teaching is underutilized in modern medical education, despite evidence that learners desire more. Logistical challenges and lack of teacher confidence are commonly cited reasons, but both can be mitigated with a deliberate approach and sufficient experience. Well-executed bedside teaching can provide lasting lessons for learners while enhancing the patient experien… Show more

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Cited by 3 publications

References 60 publications

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Creating a win-win for the health system and health Profession’s education: a direct observation clinical experience with feedback iN real-time (DOCENT) for low acuity patients in the emergency department

et al. 2022

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Background Clinical education across the professions is challenged by a lack of recognition for faculty and pressure for patient throughput and revenue generation. These pressures may reduce direct observation of patient care provided by students, a requirement for both billing student-involved services and assessing competence. These same pressures may also limit opportunities for interprofessional education and collaboration. Methods An interprofessional group of faculty collaborated in a sequential quality improvement project to identify the best patients and physical location for a student teaching clinic. Patient chief complaint, use of resources, length of stay, estimated severity of illness and student participation and evaluation of the clinic was tracked. Results Clinic Optimization and Patient Care: Five hundred and thirty-two emergency department (ED) patients were seen in the first 19 months of the clinic. A clinic located near the ED allowed for patients with higher emergency severity index and greater utilization of imaging. Patients had similar or lower lengths of stay and higher satisfaction than patients who remained in the ED (p < 0.0001). In the second clinic location, from October 2016–June 2019, 644 patients were seen with a total of 667 concerns; the most common concern was musculoskeletal (50.1%). Student Interprofessional Experience: A total of 991 students participated in the clinic: 68.3% (n = 677) medical students, 10.1% (n = 100) physician assistant students, 9.7% (n = 96) undergraduate nursing students, 9.1% (n = 90) physical therapy students, and 2.8% (n = 28) nurse practitioner students. The majority (74.5%, n = 738) of student participants worked with students from other professions. More than 90% of students reported that faculty set a positive learning environment respectful of students. However, 20% of students reported that faculty could improve provision of constructive feedback. Direct Observation: Direct observation of core entrustable professional activities for medical students was possible. Senior medical students were more likely to be observed generating a differential diagnosis or management plan than first year medical students. Conclusions Creation of a DOCENT clinic in the emergency department provided opportunities for interprofessional education and observation of student clinical skills, enriching student experience without compromising patient care.

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Creating a win-win for the health system and health Profession’s education: a direct observation clinical experience with feedback iN real-time (DOCENT) for low acuity patients in the emergency department

et al. 2022

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How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures

et al. 2022

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Background Bedside teaching (BST) is an essential and traditional clinical teaching format. It has been subject to various impediments and has transformed over time. Besides a decrease in bedside time, there has also been a didactic diversification. In order to use time at the bedside effectively and understand the current design of BST, we here offer an evidence-based insight into how BST is practiced. This may serve as a basis for a refinement of its didactic design. Methods In the current study, we investigate the interrelationships between learning content and the social as well as spatial structures of BST. To this end, we have empirically analysed almost 80 hours of video material from a total of 36 BST sessions with good interrater reliability. Results BST lasted on average 125 min, most of which was spent in plenary and less than a third of the time at the patient’s bedside. History taking was primarily practiced at the bedside while case presentations, clinical reasoning and theoretical knowledge were largely taught away from the patient. Clinical examination took place to a similar extent in the patient’s room and in the theory room. Conclusions Even though the filmed BSTs are not purely “bedside”, the teaching format investigated here is a typical example of undergraduate medical education. In order to maximize the teaching time available, a suitable learning space should be provided in addition to the bedside. Moreover, the clinical examination should be revised in its general sequence prior to the BST, and conscious decisions should be made regarding the social structure so as to optimize the potential of small groups and plenary sessions.

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Education Research: Making a Tweetorial Fly

Albin,

Ma,

Pucci

et al. 2024

Neurology Education

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Bedside Teaching in Neurology

Cited by 3 publications

References 60 publications

Creating a win-win for the health system and health Profession’s education: a direct observation clinical experience with feedback iN real-time (DOCENT) for low acuity patients in the emergency department

Creating a win-win for the health system and health Profession’s education: a direct observation clinical experience with feedback iN real-time (DOCENT) for low acuity patients in the emergency department

How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures

Education Research: Making a Tweetorial Fly

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