The Effect of Bedside Case Presentations on Patients' Perceptions of Their Medical Care

Lehmann, Lisa Soleymani; Brancati, Frederick L.; Chen, Min Chi; Roter, Debra; Dobs, Adrian S.

doi:10.1056/nejm199704173361606

Cited by 205 publications

(183 citation statements)

References 7 publications

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“…Instead, bedside rounds have been shown to positively influence patients' feelings about their hospital experience and their relationships with their physicians compared with patients whose case presentations were made in a conference room. 31,32 Given the opportunity to comment on areas for improvement, patients in our study specifically elaborated regarding pain control, communication, and efficiency problems. Although 16% of patients did not find the communication of physicians reassuring, none of the negative comments reflected problems with bedside teaching, but rather concepts such as desiring a better explanation of steps throughout the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…3 Having senior physicians present increases patient comfort during outpatient case presentations 4 and improves patient satisfaction with explanations of tests and medications. 5 However, we had concerns that teaching during a procedure may heighten patient anxiety. Patients are reluctant to be the first patient of a resident or medical student for a procedure, [6][7][8] and patients are more likely to refuse consent to have a resident perform complex procedures.…”

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confidence: 99%

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Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

Mourad

Auerbach

Maselli

et al. 2011

Journal of Hospital Medicine

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BACKGROUND:In recent years, hospital medicine programs have adopted “procedure teams” that supervise residents in performing invasive bedside procedures. The effect of procedure teams on patient satisfaction is unknown.OBJECTIVE:We sought to measure patient satisfaction with procedures performed by a hospitalist‐supervised, intern‐based procedure service (HPS) with a focus on patient perception of bedside communication.DESIGN:This was a prospective survey.METHODS:We surveyed all patients referred to the HPS for bedside thoracentesis, paracentesis, lumbar puncture, and arthrocentesis at a single academic medical center. Following each procedure, surveys were administered to English‐speaking patients who could provide informed consent. Survey questions focused on patients' satisfaction with specific aspects of procedure performance as well as the quality and impact of communication with the patient and between members of the team.RESULTS:Of 95 eligible patients, 65 (68%) completed the survey. Nearly all patients were satisfied or very satisfied with the overall experience (100%), explanation of informed consent (98%), pain control (92%), and expertise (95%) of physicians. The majority of patients were satisfied with procedure duration (88%) and in those with therapeutic procedures most (89%) were satisfied with improvement in symptoms. Hearing physicians discuss the procedure at the bedside was reassuring to most patients (84%), who felt this to be a normal part of doing a procedure (94%).CONCLUSIONS:Patients are highly satisfied with procedure performance by supervised trainees, and many patients were reassured by physician communication during the procedure. These results suggest that patient experience and teaching can be preserved with a hospitalist‐supervised procedure service. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

Mourad

Auerbach

Maselli

et al. 2011

Journal of Hospital Medicine

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“…At the same time, patients are usually happy to take part in clinical teaching sessions (Lehmann et al 1997). In addition, small student group size as well as recurring visits of the same group instead of BST sessions involving different students every time can further increase patients' willingness to participate (Fletcher et al 2005).…”

Section: Future Researchmentioning

confidence: 99%

Effects of “minimally invasive curricular surgery” – A pilot intervention study to improve the quality of bedside teaching in medical education

et al. 2009

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Background: Bedside teaching is an important element of undergraduate medical education. However, the impact of curricular course structure on student outcome needs to be determined. Aims: This study assessed changes in fourth-year medical students' evaluations of clinical teaching sessions before and after the introduction of a new course format. Method: The curricular structure of bedside teaching sessions in cardiology was modified without changing the amount of teaching time. Clinical teachers were instructed about the new teaching format and learning objectives. The new format implemented for adult but not paediatric cardiology sessions was piloted with 143 students in winter 2007/08. By computing effect sizes, evaluation results were compared to data obtained from 185 students before the intervention. Results: Significant rating increases were observed for adult cardiology teaching sessions (Cohen's d ¼ 0.66) but not paediatric cardiology sessions (d ¼ 0.22). In addition to improving the structure and organization of the course, the intervention significantly impacted on students' perceptions of their learning outcome regarding practical skills (d ¼ 0.69). Conclusions: Minimal curricular changes combined with basic faculty development measures significantly increase students' perception of learning outcome. Curricular structure needs to be considered when planning bedside teaching sessions in medical undergraduate training.

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“…Fuera de Brasil, la percepción del paciente de su participación en las clases junto a su cama también fue favorable [11].…”

Section: Discussionunclassified

Opinión de los pacientes sobre su participación en la enseñanza práctica de medicina en un hospital universitario de Brasil

et al. 2011

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IntroducciónLa pedagogía médica en Brasil se basa en un proceso enseñanza-aprendizaje compuesto por tres elementos: profesor, estudiante y paciente, con naturaleza, funciones y expectativas diferentes [1]. En el centro de esta triple relación hay un ser humano que sufre y, por lo tanto, merece una doble preocupación: la que se debe a la dignidad de un ser humano y la debida a la condición de sufrimiento humano [2].En este contexto, es importante reflexionar sobre las implicaciones pedagógicas y éticas involucradas en esta relación pedagógica [3]. ¿Cuál es la autonomía de estos pacientes durante la hospitalización en una institución de enseñanza? ¿Les gustaría rechazar ciertos procedimientos que forman parte de la instrucción práctica de los estudiantes de medicina?La ética de la educación médica ha generado hasta ahora escasa atención y reflexión [3] Patients and methods. An observational and qualitative study with interviews of patients by students from the School of Medicine at the UFPB.Results. The age of the 54 patients ranged from 20 to 77, 57,1% men and 5.0 ± 3.6 years of schooling, 85,7% said they were not uncomfortable in participating in classes, 51,8% indicated they would accept to participate even if you submit a brief discomfort, 50% have replied that they did not request consent by students.Conclusions. The perception of the patients was positive, but they seemed ambivalent in some ways. Guidelines for direct patient participation in teaching practice are necessary to preserve its training function, without harming the patient.Key words. Bioethics. Education. Inpatients. Medical. Undergraduate.Objetivo. Evaluar la percepción del paciente como participante de lecciones prácticas de medicina del hospital de la Universidad Federal de Paraíba (UFPB), Brasil.Pacientes y métodos. Estudio observacional de abordaje cuantitativo con realización de entrevistas de pacientes por estudiantes de la Escuela de Medicina de la UFPB.Resultados. La edad de los 54 pacientes osciló entre 20 y 77 años, 57,1% hombres, con 5,0 ± 3,6 años de escolaridad. El 87,9% dijeron que no se sentían incómodos en participar en las clases. El 43,9% indicaron que aceptarían participar incluso si presentaran un breve malestar. El 50% contestó que no se les había solicitado su consentimiento por parte de los estudiantes.Conclusiones. La percepción de los pacientes fue positiva, pero parecieron ambivalentes en algunos aspectos. Se precisan directrices para orientar la participación del paciente en la enseñanza práctica con el fin de preservar su función didáctica sin dañar al paciente.Palabras clave. Bioética. Educación de pregrado en medicina. Pacientes internos.

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The Effect of Bedside Case Presentations on Patients' Perceptions of Their Medical Care

Cited by 205 publications

References 7 publications

Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

Effects of “minimally invasive curricular surgery” – A pilot intervention study to improve the quality of bedside teaching in medical education

Opinión de los pacientes sobre su participación en la enseñanza práctica de medicina en un hospital universitario de Brasil

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