Teaching correct and safe bedside procedures

Fincher, R M; Pogue, L N; Cowan, Chrissy

doi:10.1097/00001888-199107000-00004

Cited by 7 publications

(3 citation statements)

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“…In the early years of the HIV epidemic, the need for an explicit approach to teaching bedside procedures because of heightened safety concerns was expressed 26 . However, approaches to teaching bedside procedures are still generally unsystematic and unstructured and have high heterogeneity 3 .…”

Section: Curriculum Foundationsmentioning

confidence: 99%

“…In the early years of the HIV epidemic, the need for an explicit approach to teaching bedside procedures because of heightened safety concerns was expressed. 26 However, approaches to teaching bedside procedures are still generally unsystematic and unstructured and have high heterogeneity. 3 Different approaches to teaching bedside procedures have been proposed, from simple strategies 27 to systematic methods that integrate validated technologies, correlate methods to clinical outcomes, and recognize how individuals learn psychomotor processes.…”

Section: Curriculum Foundationsmentioning

confidence: 99%

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Teaching and Assessing Bedside Procedures: A Standardized Cross-Disciplinary Framework for Graduate Medical Education

Vohra,

Kinni,

Gardner-Gray

et al. 2023

Acad Med

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Performing bedside procedures requires knowledge, reasoning, physical adeptness, and self-confidence; however, no consensus on a specific, comprehensive strategy for bedside procedure training and implementation is available. Bedside procedure training and credentialing processes across large institutions may vary among departments and specialties, leading to variable standards, creating an environment that lacks consistent accountability, and making quality improvement difficult. In this Scholarly Perspective, the authors describe a standardized bedside procedure training and certification process for graduate medical education with a common, institution-wide educational framework for teaching and assessing the following 7 important bedside procedures: paracentesis; thoracentesis; central venous catheterization; arterial catheterization; bladder catheterization or Foley catheterization; lumbar puncture; and nasogastric, orogastric, and nasoenteric tube placement. The proposed framework is a 4-stage process that includes 1 preparatory learning stage with simulation practice for knowledge acquisition and 3 clinical stages to guide learners from low-risk to high-risk practice and from high to low supervision. The pilot rollout took place at Henry Ford Hospital from December 2020 to July 2021 for 165 residents in the emergency medicine and/or internal medicine residency programs. The program was fully implemented institution-wide in July 2021. Assessment strategies encompass critical action checklists to confirm procedural understanding and a global rating scale to measure performance quality. A major aim of the bedside procedure training and certification was to standardize assessments so that physician trainers from multiple specialties could train, assess, and supervise any participating trainee, regardless of discipline. The authors list considerations revealed from the pilot rollout regarding electronic tracking systems and several benefits and implementation challenges to establishing institution-wide standards. The proposed framework was assembled by a multidisciplinary physician task force and will assist other institutions in adopting best approaches for training physicians in performing these critically important and difficult-to-perform procedures.

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Section: Curriculum Foundationsmentioning

confidence: 99%

Section: Curriculum Foundationsmentioning

confidence: 99%

Teaching and Assessing Bedside Procedures: A Standardized Cross-Disciplinary Framework for Graduate Medical Education

Vohra,

Kinni,

Gardner-Gray

et al. 2023

Acad Med

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“…Bedside teaching (BST) involves clinical teaching in the presence of the patient, usually with a three-way relationship between clinical teacher, student and the patient [ 1 ]. BST is considered essential to help students develop their understanding of the doctor-patient relationship (particularly of patient-centred care), and to facilitate the development of students clinical reasoning, clinical and communication skills and professionalism [ 2 – 4 ]. The student, whether a medical student or graduate trainee in the speciality, experienced not just how to assess disease, but how to personally and professionally address the human impact of illness that perhaps cannot be conveyed by an actor [ 1 – 3 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of a questionnaire exploring patient attitudes towards bedside teaching

et al. 2022

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Background Bedside teaching (BST) facilitates medical education and has reduced in practice, often due to patient-related concerns. This study aimed to validate a questionnaire exploring patients attitudes towards BST. Methods International guidelines for questionnaire development were followed. Seven steps were included: literature review, patient interviews, development of clear and understandable items, expert validation, cognitive interviewing and pilot testing. Statistical analyses included exploratory factor analysis, internal consistency, investigation of demographic influences and discriminant validity across subscales. Results Following the literature review, 32 interviews were conducted. Potential items were developed, reviewed and adapted. Experts in medical education and statistics reviewed the draft questionnaire. Fifteen patients consented to cognitive testing and 401 consenting patients completed the final version. The median age of participants was 35 years of age (range: 18 to 70 years). Participants included women attending for antenatal (40%), postnatal (32%) and gynaecology issues (28%). Just under one third (29%) had taken part in medical student teaching previously. Statistical analyses found a two-factor solution, consisting of Educate medical professionals and Conditions for participation subscales with good internal consistency; responses did not vary by age or education. Participants who had opted-in for teaching in the ward and bedside endorsed higher levels of Educate medical professionals, suggesting discriminant validity. A majority of patients (> 92%) reported that they were happy to be involved in BST. Patients believed that they should not be asked to participate in BST should they feel stressed or unwell (68.2%). Conclusion This study shows extensive patient support for BST, independent of age or education. The desire to educate is a strong motivating factor. This strong support by patients for BST is an area that medical schools and universities can potentially develop. Future versions of this questionnaire may include virtual bedside teaching, in the context of social distancing.

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Collaboration in the preparation of the generalist physician

et al. 1994

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Collaborative efforts among health care professionals and institutions at all levels will be essential to the increased production of generalist physicians. There have been many successful collaborations in education and patient care among certifying boards, faculty, physicians in practice, specialists, generalists, and non-physician health professionals, as well as among the three generalist specialties. Recommended strategies to encourage collaboration in the preparation of generalist physicians include: creation of an institutional collaborative curriculum committee; design of a longitudinal curriculum on collaboration for physicians-in-training and other health professionals; implementation of collaborative patient care in ambulatory care teaching clinics; development of integrated systems of care that link inpatient, outpatient, and community-based health services; and education of physicians-in-training in these and other collaborative and co-practice models of patient care.

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Teaching correct and safe bedside procedures

Cited by 7 publications

References 0 publications

Teaching and Assessing Bedside Procedures: A Standardized Cross-Disciplinary Framework for Graduate Medical Education

Teaching and Assessing Bedside Procedures: A Standardized Cross-Disciplinary Framework for Graduate Medical Education

Validation of a questionnaire exploring patient attitudes towards bedside teaching

Collaboration in the preparation of the generalist physician

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