1. Bedside Teaching (aka Teaching With the Patient Present!)

2. Originally developed by Glen Drobot, MD
Section of General Internal Medicine

3. Bedside Teaching - Objectives
By the end of this session, the learner will be able to:
Provide a definition of bedside teaching
List advantages and disadvantages of incorporating bedside teaching into work rounds
Describe the three key steps required for effective bedside teaching
Discuss the integration of bedside teaching into work & attending rounds

4. Bedside Teaching
“In what may be called the natural method of teaching, the student begins with the patient, continues with the patient and ends his study with the patient, using books and lectures as tools, as means to an end. …”

5. Bedside Teaching
“For the junior student in medicine and surgery it is a safe rule to have no teaching without a patient for a text, and the best teaching is that taught by the patient himself.” Sir William Osler, Address to the New York Academy of Medicine, 1903

6. What is Bedside Teaching (Not)?
Not synonymous with work rounds or attending rounds, but can be used as a tool for both
Not conference room rounds, hallway rounds, or “door-jamb” rounds

7. What is Bedside Teaching?
An experience at the bedside of a patient where both the patient and student can learn simultaneously
The term “bedside” can be broadened to include the outpatient setting, or any other setting where patient-physician interaction occurs

8. Advantages/Disadvantages of Bedside Teaching
Take 5-10 minutes
Pair up with your neighbour
Come up with 3 advantages and 3 disadvantages of bedside teaching

9. Advantages?

10. Disadvantages?

11. Three Steps for Effective Bedside Teaching
Planning the Bedside Teaching Session
The Bedside Teaching Session
Debriefing after the Bedside Teaching Session

12. Planning the Bedside Teaching Session
Set time limits and plan accordingly
Review previous day’s admissions
Set clear objectives
Decide whether to observe or model
Plan for closure with learners and patients
Brief the learners and patients beforehand

13. The Bedside Teaching Session
Focus on sensory experiences
not discussions about differential diagnoses
Review aspects of obtaining medical history or demonstrating physical examination

14. The Bedside Teaching Session
Involve the patients and family
Model professionalism and ethical behaviour
Ask questions to probe higher-level learner, not just recall
Say “thank you” to the patient

15. Debriefing after the Bedside Teaching Session
Faculty Member (superviser)
Plan for immediate feedback to learners
Create a non-threatening environment so that feedback can be received by learners
Review process (what worked and what didn’t?)

16. Debriefing after the Bedside Teaching Session
With the learner review:
findings (what did you observe?)
insights (what does it mean?)
objectives (what did you learn?)
questions (what still needs to be learned?)
Reflect on what has been learned and how to apply it to the next encounter

17. Model of Bedside Teaching
Janicik and Fletcher, (2003) Teaching at the bedside: a new model, Medical Teacher, Vol. 25, No. 2, 2003, pp. 127–130

18. Video
What was done well?
What could be improved?

19. Bedside Teaching - Summary
Definition of bedside teaching
There are advantages and disadvantages of incorporating bedside teaching into work rounds
Effective bedside teaching requires planning, input from teacher and learners during the encounter, and debriefing

20. Objectives By the end of this session, the learner will be able to:
Provide a definition of bedside teaching
List advantages and disadvantages of incorporating bedside teaching into work rounds
Describe the three key steps required for effective bedside teaching
Discuss the integration of bedside teaching into work & attending rounds

21. Thanks!

22. The 5 Micro-Skills Step 1: Get a commitment
Step 2: Probe for supporting evidence
Step 3: Reinforce what was done well
Step 4: Correct errors, suggest improvements
Step 5: Teach general rules (take-home points)
(Note: steps 3 – 5 can be in any order)