Innovative integrative bedside teaching model improves tutors’ self-assessments of teaching skills and attitudes

Abstract

IntroductionPatient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST) practiced during tutor training workshop and its resulting effect on practitioners’ self assessment of teaching skills and perceptions.MethodsOne-day tutor training workshop included theoretical knowledge supplementation regarding tutors’ roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared.ResultsAnalysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5) compared with pre-training (mean 2.6, SD 0.6; p<0.001) with significant increase in most examined parameters. Significantly improved tutor's roles internalization was demonstrated after training completion (mean 3.7, SD 0.3) compared with pre-workshop (mean 3.5 SD 0.5; p=0.002).DiscussionSuccessful BST involves combination of clinical and communication skills. BST model practiced during the workshop may contribute to improved teaching skills in this challenging environment.

Perceptions of Lecturers, Administrators, and Students About the Workplace as Learning Environment for Undergraduate Medical Students at a National Referral and Teaching Hospital in Uganda

“… 31 An environment fraught with shortages can be quite uncomfortable and pose a big challenge to clinical teaching. 32 …”

“…The reported decline in the use of the bedside for learning important clinical skills for medical students has been reported elsewhere. 32 , 41 Based on the one-minute preceptorship model, learning at the workplace should be such that every patient encounter is a learning opportunity. 3 This can only be possible when the lecturers are available, competent, and willing to teach, with adequate protected time and space, as well as students with the right experience, backgrounds and interest.…”

Workplace Learning for Undergraduate Medical Students at a National Referral and Teaching Hospital as Perceived by Lecturers, Administrators and Students of a Contemporary Medical Training University in Uganda.

“…Workplace learning is frequently undermined by challenges such as time pressure due to competing demands, large numbers of students and patients, concerns about patient safety and the attendant litigation and these challenges can impede competence development (17).…”

“…There was also a shortage of designated protected spaces for teaching and learning. A supportive workplace learning environment should have protected spaces, so that the lecturer and the students can discuss the theoretical concepts underlying the patient's condition in more detail, as well as other issues related to a patient's illness, such as investigations required, differential diagnoses (handling the "what if" questions), treatment options and prognosis (17). During preparation for the clinical session by the lecturer, the patients should be assured of privacy and confidentiality (3,7).…”

“…The reported decline in the use of the bedside for passing on important clinical skills to medical students has been reported elsewhere (17,45). Workplace learning should be such that every patient encounter is a learning opportunity; however, this is only possible when the lecturers are available, competent and willing to teach.…”