Teaching Clinical Medical Students

  • Mario C. Ponce
  • Jeremy B. Richards
Part of the Respiratory Medicine book series (RM)


Pulmonary, critical care, and sleep medicine encompasses a wide variety of clinical settings, from ambulatory clinic to in-patient consult services and to the intensive care unit. Teaching medical students in these heterogeneous clinical settings can be challenging, as clinical obligations and students’ needs and expectations can vary. This chapter focuses on strategies to provide optimal teaching to medical students in in-patient clinical settings, including the Pulmonary Consult service and the ICU. Core strategies for engaging and effectively teaching students can be applied in different clinical settings and for different clinical scenarios, however, to address the heterogeneity of teaching clinical students. Specifically, best practices in teaching medical students in clinical settings include prioritizing thoughtful preparation for teaching, encouraging student autonomy and ownership, and emphasizing critical thinking skills and application of knowledge to solve clinical problems. Developing a learning environment that encourages inquisitiveness and open communication can promote students to develop self-directed learning skills, which will significantly add to the educational value of working and learning in the clinical setting.


Undergraduate medical education Medical students Critical thinking Autonomy Professionalism 


  1. 1.
    Fessler HE. Undergraduate medical education in critical care. Crit Care Med. 2012;40:3065–9.CrossRefGoogle Scholar
  2. 2.
    O’Connor E, Moore M, Cullen W, Cantillon P. A qualitative study of undergraduate clerkships in the intensive care unit: it’s a brand new world. Perspect Med Educ. 2017;6(3):173–81. Med Teach. 2017 Mar;39(3):244–9.CrossRefGoogle Scholar
  3. 3.
    Khan N, Jovestani K, Spencer C, Man R, Pugh M, Woywodt A. Twelve tips on how to establish a new undergraduate firm on a critical care unit.Google Scholar
  4. 4.
    Whereat SE, McLean AS. Survey of the current status of teaching intensive care medicine in Australia and New Zealand medical schools. Crit Care Med. 2012;40(2):430–4.CrossRefGoogle Scholar
  5. 5.
    Dehmer JJ, Amos KD, Farrell TM, Meyer AA, Newton WP, Meyers MO. Competence and confidence with basic procedural skills: the experience and opinions of fourth-year medical students at a single institution. Acad Med. 2013;88(5):682–7.CrossRefGoogle Scholar
  6. 6.
    Gandomkar R, Sandars J. Clearing the confusion about self-directed learning and self-regulated learning. Med Teach. 2018;40:862–3. 1–2.CrossRefGoogle Scholar
  7. 7.
    Gandomkar R, Mirzazadeh A, Jalili M, Yazdani K, Fata L, Sandars J. Self-regulated learning processes of medical students during an academic learning task. Med Educ. 2016;50(10):1065–74.CrossRefGoogle Scholar
  8. 8.
    Berkhout JJ, Helmich E, Teunissen PW, van den Berg JW, van der Vleuten CP, Jaarsma AD. Exploring the factors influencing clinical students’ self-regulated learning. Med Educ. 2015;49(6):589–600.CrossRefGoogle Scholar
  9. 9.
    Kassirer JP. Teaching clinical reasoning: case-based and coached. Acad Med. 2010;85(7):1118–24.CrossRefGoogle Scholar
  10. 10.
    Linn A, Khaw C, Kildea H, Tonkin A. Clinical reasoning – a guide to improving teaching and practice. Aust Fam Physician. 2012;41(1–2):18–20.PubMedGoogle Scholar
  11. 11.
    Almoosa KF, Goldenhar LM, Puchalski J, Ying J, Panos RJ. J Grad Med Educ. 2010;2(4):555–61.CrossRefGoogle Scholar
  12. 12.
    Merchant NB, Federman DG. Bedside rounds valued but not preferred: perceptions of internal medicine residents and attending physicians in a diverse academic training program. South Med J. 2017;110(8):531–7.CrossRefGoogle Scholar
  13. 13.
    Lim KG, Dunn WF, Klarich KW, Afessa B. Internal medicine resident education in the medical intensive care unit: the impact on education and patient care of a scheduling change for didactic sessions. Crit Care Med. 2005;33(7):1534–7.CrossRefGoogle Scholar
  14. 14.
    Croley WC, Rothenberg DM. Education of trainees in the intensive care unit. Crit Care Med. 2007;35(2):S117–21.CrossRefGoogle Scholar
  15. 15.
    Çoruh B, Kritek P. A case-based critical care curriculum for resident physicians. MedEdPORTAL. 2012;8:9276. Scholar
  16. 16.
    Santhosh L, Jain S, Brady A, Sharp M, Carlos WG. Intensive care unit educators: a multicenter evaluation of behaviors residents value in attending physicians. Ann Am Thorac Soc. 2017;14(4):513–6.CrossRefGoogle Scholar
  17. 17.
    Hutul OA, Carpenter RO, Tarpley JL, Lomis KD. Missed opportunities: a descriptive assessment of teaching and attitudes regarding communication skills in a surgical residency. Curr Surg. 2006;63(6):401–9.CrossRefGoogle Scholar
  18. 18.
    Hammoud MM, Dalymple JL, Christner JG, Stewart RA, Fisher J, Margo K, Ali II, Briscoe GW, Pangaro LN. Medical student documentation in electronic health records: a collaborative statement from the Alliance for clinical education. Teach Learn Med. 2012;24(3):257–66.CrossRefGoogle Scholar
  19. 19.
    Kumar AB, Hata JS, Bayman EO, Krishnan S. Implementing a hybrid web-based curriculum for an elective medical student clerkship in a busy surgical intensive care unit (ICU): effect on test and satisfaction scores. J Surg Educ. 2013;70(1):109–16.CrossRefGoogle Scholar
  20. 20.
    Kessler CS, Chan T, Loeb JM, Malka ST. I’m clear, you’re clear, we’re all clear: improving consultation communication skills in undergraduate medical education. Acad Med. 2013;88(6):753–8.CrossRefGoogle Scholar
  21. 21.
    Dowell J, Dent JA, Duffy R. What to do about medical students with unsatisfactory consultation skills? Med Teach. 2006;28(5):443–6.CrossRefGoogle Scholar
  22. 22.
    Kessler CS, Tadisina KK, Saks M, Franzen D, Woods R, Banh KV, Bounds R, Smith M, Deiorio N, Schwartz A. The 5Cs of consultation: training medical students to communicate effectively in the emergency department. J Emerg Med. 2015;49(5):713–21.CrossRefGoogle Scholar
  23. 23.
    Windish DM, Price EG, Clever SL, Magaziner JL, Thomas PA. Teaching medical students the important connection between communication and clinical reasoning. J Gen Intern Med. 2005;20(12):1108–13.CrossRefGoogle Scholar
  24. 24.
    Schmidt HG, Mamede S. How to improve the teaching of clinical reasoning: a narrative review and a proposal. Med Educ. 2015;49(10):961–73.CrossRefGoogle Scholar
  25. 25.
    McMillan WJ. Teaching for clinical reasoning – helping students make the conceptual links. Med Teach. 2010;32(10):e436–42.CrossRefGoogle Scholar
  26. 26.
    Wittels K, Wallenstein J, Patwari R, Patel S. Medical student documentation in the electronic medical record: patterns of use and barriers. West J Emerg Med. 2017;18(1):133–6.CrossRefGoogle Scholar
  27. 27.
    Cohn SL. The role of the medical consultant. Med Clin N Am. 2003;87:1–6.CrossRefGoogle Scholar
  28. 28.
    Chudgar SM, Cox CE, Que LG, Andolsek K, Clay AS, et al. Current teaching and evaluation methods in critical care medicine: has accreditation Council for Graduate Medical Education affected how we practice and teach in the intensive care unit? Crit Care Med. 2009;37(1):49–60.CrossRefGoogle Scholar
  29. 29.
    Association of American Medical Colleges (US). Core Entrustable Professional Activities for Entering Residency (Updated); [cited 2018 Aug 7]. Available from:
  30. 30.
    Watling CJ, Ginsburg S. Assessment, feedback and the alchemy of learning. Med Educ. 2018. [Epub ahead of print].Google Scholar
  31. 31.
    van der Vleuten CPM, Schuwirth LWT, Scheele F, Driessen EW, Hodges B. The assessment of professional competence: building blocks for theory development. Best Pract Res Clin Obstet Gynaecol. 2010;24(6):703–19.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mario C. Ponce
    • 1
  • Jeremy B. Richards
    • 2
  1. 1.Division of Pulmonary, Critical Care and Sleep MedicineMedical University of South CarolinaCharlestonUSA
  2. 2.Harvard Medical School, Shapiro Institute Center for Education, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical CenterBostonUSA

Personalised recommendations