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Part of the book series: Respiratory Medicine ((RM))

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Abstract

In this chapter, we explore bedside teaching and its importance in clinical medicine. Bedside teaching was a customary part of training and formalized rounding on the inpatient floor and ICU until recently. As modern medicine has evolved with the advent of new technology, specialized facilities, and duty hour restrictions for trainees, bedside rounding has been depriotitized. Nevertheless, bedside teaching is as relevant today as it was in the mid-seventeenth century. Currently, other teaching modalities have replaced bedside teaching due to its perceived time constraints and emphasis on maximizing efficiency. However, there are countless benefits for bedside teaching and compelling evidence that bedside teaching should play a central role in physician training. Some misperceptions about the limitations of bedside teaching have propagated these sentiments, but the key to success of bedside teaching is through planning and preparation. Included in this chapter are best practice measures that teaching physicians may use to improve not only clinical teaching, but patient centered rounding in the wards, ICU and even in the emergency department and the outpatient settings. The fruits of successful bedside teaching are innumerable and commitment to this modality can be enriching not only to trainees but also to patients and their families’ understanding.

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References

  1. Peters M, ten Cate O. Bedside teaching in medical education: a literature review. Perspect Med Educ. 2014;3(2):76–88. https://doi.org/10.1007/s40037-013-0083-y.

    Article  PubMed  Google Scholar 

  2. Osler S. On the need of a radical reform in our methods of teaching senior students. Med News. 1903;82:49–53.

    Google Scholar 

  3. Nair BR, Coughlan JL, Hensley MJ. Student and patient perspectives on bedside teaching. Med Educ. 1997;31(5):341–6. https://doi.org/10.1046/j.1365-2923.1997.00673.x.

    Article  CAS  PubMed  Google Scholar 

  4. Cushing H. The life of Sir William Osler. New York: Oxford University Press; 1956.

    Google Scholar 

  5. Linfors EW, Neelon FA. The case for bedside rounds. N Engl J Med. 1980;303(21):1230–3. https://doi.org/10.1056/NEJM198011203032110.

    Article  CAS  PubMed  Google Scholar 

  6. Osler W. Osler, the teacher. Johns Hopkins Hosp Bull. 1919;30:198.

    Google Scholar 

  7. Collins GF, Cassie JMDC. The role of the attending physician in clinical training. Acad Med. 1978;53(5):429–31.

    Article  CAS  Google Scholar 

  8. Crumlish CM, Yialamas MA, McMahon GT. Quantification of bedside teaching by an academic hospitalist group. J Hosp Med. 2009;4(5):304–7. https://doi.org/10.1002/jhm.540.

    Article  PubMed  Google Scholar 

  9. Verghese A, Brady E, Kapur CC, Horwitz RI. The bedside evaluation: ritual and reason. Ann Intern Med. 2011;155(8):550. https://doi.org/10.7326/0003-4819-155-8-201110180-00013.

    Article  PubMed  Google Scholar 

  10. Reed DA, Levine RB, Miller RG, et al. Effect of residency duty-hour limits. Arch Intern Med. 2007;167(14):1487. https://doi.org/10.1001/archinte.167.14.1487.

    Article  PubMed  Google Scholar 

  11. Qureshi Z. Back to the bedside: the role of bedside teaching in the modern era. Perspect Med Educ. 2014;3(2):69–72. https://doi.org/10.1007/s40037-014-0111-6.

    Article  PubMed  PubMed Central  Google Scholar 

  12. LaCombe MA. On bedside teaching. Ann Intern Med. 1997;126(3):217–20.

    Article  CAS  Google Scholar 

  13. Chudgar SM, Cox CE, Que LG, Andolsek K, Knudsen NW, Clay AS. Current teaching and evaluation methods in critical care medicine: has the 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. https://doi.org/10.1097/CCM.0b013e31819265c8.

    Article  PubMed  Google Scholar 

  14. Cox CE, Carson SS, Ely EW, et al. Effectiveness of medical resident education in mechanical ventilation. Am J Respir Crit Care Med. 2003;167(1):32–8. https://doi.org/10.1164/rccm.200206-624OC.

    Article  PubMed  Google Scholar 

  15. Popkin J, Eissa K, Mazor K, Lemay C. The “16-hour rule”: a giant step, but in which direction? Am J Med. 2015;128:922–8.

    Article  Google Scholar 

  16. Fitzgerald FT. Bedside teaching. West J Med. 1993;158(4):418–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Ramani S, Orlander JD, Strunin L, Barber TW. Whither bedside teaching? A focus-group study of clinical teachers. Acad Med. 2003;78(4):384–90.

    Article  Google Scholar 

  18. Gonzalo JD, Chuang CH, Huang G, Smith C. The return of bedside rounds: an educational intervention. J Gen Intern Med. 2010;25(8):792–8. https://doi.org/10.1007/s11606-010-1344-7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Almoosa KF, Goldenhar LM, Puchalski J, Ying J, Panos RJ. Critical care education during internal medicine residency: a national survey. J Grad Med Educ. 2010;2(4):555–61. https://doi.org/10.4300/JGME-D-10-00023.1.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bokken L, Rethans J-J, Scherpbier AJJA, van der Vleuten CPM. Strengths and weaknesses of simulated and real patients in the teaching of skills to medical students: a review. Simul Healthc J Soc Simul Healthc. 2008;3(3):161–9. https://doi.org/10.1097/SIH.0b013e318182fc56.

    Article  Google Scholar 

  21. Mangione S. Cardiac auscultatory skills of physicians-in-training: a comparison of three English-speaking countries. Am J Med. 2001;110(3):210–6.

    Article  CAS  Google Scholar 

  22. Cooper D, Beswick W, Whelan G. Intensive bedside teaching of physical examination to medical undergraduates: evaluation including the effect of group size. Med Educ. 1983;17(5):311–5.

    Article  CAS  Google Scholar 

  23. Heckmann JG, Bleh C, Dutsch M, Lang CJG, Neundurfer B. Does improved problem-based teaching influence students? Knowledge at the end of their neurology elective? An observational study of 40 students. J Neurol. 2003;250(12):1464–8. https://doi.org/10.1007/s00415-003-0255-5.

    Article  PubMed  Google Scholar 

  24. Landry M-A, Lafrenaye S, Roy M-C, Cyr C. A randomized, controlled trial of bedside versus conference-room case presentation in a pediatric intensive care unit. Pediatrics. 2007;120(2):275–80. https://doi.org/10.1542/peds.2007-0107.

    Article  PubMed  Google Scholar 

  25. Medicine I of. In: Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, editors. Clinical practice guidelines we can trust: standards for developing trustworthy clinical practice. Washington, DC: National Academies Press (US); 2011. https://doi.org/10.17226/13058.

    Chapter  Google Scholar 

  26. Vazquez R, Vazquez Guillamet C, Adeel Rishi M, et al. Physical examination in the intensive care unit: opinions of physicians at three teaching hospitals. Southwest J Pulm Crit Care. 2015;10(1):34–43. https://doi.org/10.13175/swjpcc165-14.

    Article  Google Scholar 

  27. Oropello JM, Pastores SM, Kvetan V. In: Brian B, Christie N, editors. Critical care. 1st ed. New York: McGraw Hill Medical; 2017.

    Google Scholar 

  28. Carlos WG, Kritek PA, Clay AS, Luks AM, Thomson CC. Teaching at the bedside: maximal impact in minimal time. Ann Am Thorac Soc. 2016;13(4):545–8. AnnalsATS.201601-018AS. https://doi.org/10.1513/AnnalsATS.201601-018AS.

    Article  PubMed  Google Scholar 

  29. Pitt MB, Orlander JD. Bringing mini-chalk talks to the bedside to enhance clinical teaching. Med Educ Online. 2017;22(1):1–7. https://doi.org/10.1080/10872981.2017.1264120.

    Article  Google Scholar 

  30. Roop SA, Pangaro L. Effect of clinical teaching on student performance during a medicine clerkship. Am J Med. 2001;110(3):205–9.

    Article  CAS  Google Scholar 

  31. Irby DM. Excellence in clinical teaching: knowledge transformation and development required. Med Educ. 2014;48(8):776–84. https://doi.org/10.1111/medu.12507.

    Article  PubMed  Google Scholar 

  32. Cunningham AS, Blatt SD, Fuller PG, Weinberger HL. The art of precepting. Arch Pediatr Adolesc Med. 1999;153(2):114–6. https://doi.org/10.1001/archpedi.153.2.114.

    Article  CAS  PubMed  Google Scholar 

  33. Aagaard E, Teherani A, Irby DM. Effectiveness of the one-minute preceptor model for diagnosing the patient and the learner: proof of concept. Acad Med. 2004;79(1):42–9.

    Article  Google Scholar 

  34. Wolpaw T, Papp KK, Bordage G. Using SNAPPS to facilitate the expression of clinical reasoning and uncertainties: a randomized comparison group trial. Acad Med. 2009;84(4):517–24. https://doi.org/10.1097/ACM.0b013e31819a8cbf.

    Article  PubMed  Google Scholar 

  35. Bing-You RG, Sproul MS. Medical students’ perceptions of themselves and residents as teachers. Med Teach. 1992;14(2–3):133–8.

    Article  CAS  Google Scholar 

  36. Weiss V, Needlman R. 1998 undefinedTo teach is to learn twice: resident teachers learn more. Arch Pediatr. 1998;158:190–2.

    Google Scholar 

  37. Ramani S. Twelve tips to improve bedside teaching. Med Teach. 2003;25(2):112–5. https://doi.org/10.1080/0142159031000092463.

    Article  PubMed  Google Scholar 

  38. Telner D, Bujas-Bobanovic M, Chan D, et al. Game-based versus traditional case-based learning: comparing effectiveness in stroke continuing medical education. Can Fam Physician. 2010;56(9):e345–51.

    PubMed  PubMed Central  Google Scholar 

  39. Akl EA, Kairouz VF, Sackett KM, et al. Educational games for health professionals. In: Akl EA, editor. Cochrane database of systematic reviews. Chichester: Wiley; 2013. p. CD006411. https://doi.org/10.1002/14651858.CD006411.pub4.

    Chapter  Google Scholar 

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Correspondence to Terese C. Hammond .

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Bishara, J., Hammond, T.C. (2019). Teaching at the Bedside. In: Kritek, P., Richards, J. (eds) Medical Education in Pulmonary, Critical Care, and Sleep Medicine. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-10680-5_7

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  • DOI: https://doi.org/10.1007/978-3-030-10680-5_7

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