“Medicine is learned by the bedsideand not in the classroom.”

Sir William Osler

Crumlish CM, et al. Quantification of Bedside Teaching by an Academic Hospitalist Group. J Hospital Medicine 2009; 4:304-7.

82%

of residents want MORE

94%

“bedside teaching timeis valuable”

Bedside Teaching

Sameer D. Khatri, M.D.

Faculty Development Fellow

Take home points

• Everyone has something to offer

• Make a road map

• Stay attentive and be flexible

Learning objectives

• List obstacles to bedside teaching

• Identify advantages

• Try out models for bedside teaching

• Discuss ways to overcome obstacles

• Plan integrating into rounds

Who learns on rounds?Read 10%

Hear 20%

See 30%

See & Hear 50%

Say & Write 70%

Do 90%

Dale, E. Audiovisual Methods in Teaching, 1969, NY: Dryden

So what’s stopping us???

•List obstacles to performing bedside rounds

Barriers from the survey

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

•Describe the advantagesto bedside rounds

What do people value about clinical bedside teaching?• See/teach PE skills

and provide immediate feedback

• Demonstrate professionalism / teach art of medicine

• Get patients involved

• Clarify patient issues

• Pt-centered care

• PE teaching

• Interpersonal skills

• Communication skills

• Integrating clinical exam w/ dx & mgmt decisions

Crumlish CM, et al. 2009MAMC FM, 2012

How can we do it?

• Follow a 12-step model

• Follow a 3-domain model

• Make up our own model

Road maps and focused teaching

• Pick one model

• Pick a real case

• Work through the steps

Take 15 minutes

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• Structured time

• Targeted learning points

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move!

• Make it a part of your everyday routine

• Worth the effort

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Focus on key learning points

• Brush up on skills likely to be covered

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Ask for permission in advance

• Team introduction / get patient involved

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

• Be flexible

Strategies to increaseBedside Teaching

See handout

Taking it to the Ward

What can we commit to now?

Learning objectives

• Listed obstacles to bedside teaching

• Identified advantages

• Tried out models for bedside teaching

• Found ways to overcome obstacles

• Planned integration into rounds

Take home points

• Everyone has something to offer

• Make a road map and follow it

• Stay attentive and flexible

Questions&

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