Patient perspectives of bedside teaching in an obstetrics, Gynaecology and neonatology hospital

Abstract

Background: Osler taught doctors to "have no teaching without a patient for a text, and the best teaching is that taught by the patient himself". Bedside teaching (BST) facilitates clinical practice of skills, teaches empathy, instils confidence and builds on patient-doctor relationships. However, its use has declined dramatically due to concerns regarding privacy and autonomy. Most of the research in this area concentrates on medical student or academic opinion of BST using survey based methods. This qualitative study aimed to explore the patient's experiences and opinions of BST. Methods: With ethical approval a qualitative study was conducted using semi-structured interviews which were examined using Thematic Analysis. Patients who had participated in a BST tutorial were invited to participate and gave written consent after discussion with a study researcher.Results: Twenty-two patients were interviewed (obstetrics ante-natal [n = 10], obstetrics post-natal [n = 5] and gynaecology [n = 7]) ranging from ages 24-80 yrs. Four major themes were identified, with 11 sub-themes. The major themes included (i) Professional Mannerisms (ii) Privacy and Personal Wellbeing (iii) Quality of Patient Experience of BST and (iv) Clinical Experience and Learning Importance. The reaction of patients toward teaching at the bedside was altruistic and positive, with importance placed on learning. Conclusion: This research supports the concept of patient focused learning, and can reassure faculty that patients largely support its continuation as an integral component in education. Future research aims to extend this assessment to other patient groups with the aim of learning from and improving their experience.

Patient outlook on bedside teaching in a medical school

“…14 Even in ob/gyn and neonatology departments, patients accepted bedside teaching as an important learning tool for students, and female patients saw themselves as contributing to teaching (‘patient as teacher’). 15 It has been observed that patients participate in bedside teaching with a sense of altruism. 16 …”

Validation of a questionnaire exploring patient attitudes towards bedside teaching

“…Two types of bedside teaching occur within this hospital, full details of which are published elsewhere [ 25 ]. In brief, the first type is a senior midwife led multidisciplinary team ward round occurring every morning and based on the principles of family centred care [ 23 ].…”

“…The second type is a teaching ward round occurring two to three times a week during term time, focused on education of medical students, following standard principles of Choice, Consent and Confidentiality [ 29 ] and led by trained medical educators. While the second type of BST was the focus of the qualitative research study [ 25 ], both types are referenced in the development of this questionnaire.…”

“…Clinical learning was prioritised by patients as an important part of medical education. Patients showed altruism and positivity towards BST [ 25 ]. Limitations of this study were that it only focused on people who had experienced BST, and the majority of participants were university educated, thus studying a limited group.…”

Simulation Based Clinical Skill Training; A Need Of Time

“…Due to the constantly decreased exposure of the undergraduate medical students to this critically important aspect of their teaching, they are lacking in mastering clinical skills (3). The reasons for the decline in bedside teaching are multiple; busy hospitals, increased patient turnover, busy senior clinical faculty, increase in paperwork with no extra time allotment for such tasks, increase in patient's privacy issues and legal aspects are the few common reasons (4). Incidences of preventable medical errors and patient safety concerns are a few other major concerns that have led to the decline in bedside teaching (5) (6).…”