Assessment Score Comparison of Knowledge and Clinical Reasoning of Medical Student Educated by Bedside or Conference Room Teaching in Internal Medicine Ward

Sayyd Gholamreza Mortazavimoghaddam

doi:10.15171/rdme.2017.018

Abstract

Background: Evidence shows that bedside teaching is declining in recent years. One reason is the expectation for students to earn credit. Here, the impact of education method on undergraduate assessment score will be tested. Methods: This is a quasi-experimental study conducted with 66 undergraduate medical students who were allocated into two matched groups on the basis of a pulmonary pathophysiology course score in the internal medicine department of the Birjand University of Medical Sciences (Iran). Chronic obstructive pulmonary disease (COPD) was chosen as the theme of this education. After groups were allocated, training was conducted with 36 students using the Traditional Patient’s Bedside Teaching (Tr-BT) method and for 30 students using the Conference Room Case Presentations (Cr-CP) method. Evaluation were conducted at the end of the three-month course period using the Multiple-Choice Questions (MCQ) and Key Feature (KF) examination. Data were analyzed using independent t tests, Mann-Whitney U, and the chi-square test. Results: Among the collected student the scores of KF, inward ratings and MCQ examinations in intern vs extern were (8.58 ± 1.46 vs 8.31 ± 1.58; P = 0.65), (14.75±1.54 vs 15.51±1.88; P = 0.08),( 10.77 ± 2.20 vs 10.47 ± 1.61; P = 0.55) respectively. The mean of the pulmonary pathophysiology score was 13.03 ± 1.66 in the Tr-BT group compared with 12.67 ± 1.92 in the Cr-CP group (P = 0.23). The means of the MCQ scores were 10.07 ± 2.13 and 11.37 ± 1.56 in the Tr-BT and Cr-CP groups, respectively (P = 0.007). Conclusion: The score of the MCQ exam was significantly higher in the group taught using the Cr-CP method. Students and teachers may prefer Cr-CP. To increase interest in bedside teaching, the assessment methods of medical students should be based on practical and clinical judgment evaluation.

Highlights

Bedside teaching has been proposed as one of the ideal methods in medical education
While most doctors would agree that bedside teaching is a necessity in medical educations, in practice the subject is often ignored, so that in 1960 approximately 75% of medical education was conducted at bedside
Among student allocated to the conference room case presentations method group, five did not attend in class and were excluded from the study, and the remaining 30

Summary

Introduction

Bedside teaching has been proposed as one of the ideal methods in medical education. Skills of history taking, physical examination, professional attitude and a comprehensive diagnosis and treatment approach to patients are instructed by this manner. Students learn clinical reasoning and clinical problem solving at the bedside of patients.[1,2,3,4] While all human aspects are considered, a real patient provides an opportunity to be trained in real-world procedures.[5] While most doctors would agree that bedside teaching is a necessity in medical educations, in practice the subject is often ignored, so that in 1960 approximately 75% of medical education was conducted at bedside This amount has dropped to somewhere around 8% to 19%.6. To increase interest in bedside teaching, the assessment methods of medical students should be based on practical and clinical judgment evaluation

Results

Discussion

Conclusion