Moving The Patient Bedside Into The Tutorial Room: A Medical Classroom For The Future

Abstract

One of the goals of educational reform is to preserve the most effective components of traditional teaching while introducing new approaches that enhance learning. Such an integrative approach requires close collaboration and experimentation among faculty, educators, and students. Purpose: To design and pilot a high-tech learning environment that enables the seamless integration between traditional pedagogy and the patient bedside. We hypothesized that such a classroom could provide a robust platform for testing a variety of educational approaches. Methods: A group of educators worked to conceptualize an all-inclusive Medical Classroom for the Future. The intent was to provide an environment which could bridge the lecture, tutorial, and laboratory experience of the preclinical years with the bedside teaching, advanced debriefing, and competency assessment of the clinical years. Each of four classrooms was outfitted (1) as a traditional small group tutorial room, complete with a blackboard and conference table, and (2) as a patient care room with a stretcher and high-fidelity patient simulator (which could also accommodate standardized patients). The two modalities (tutorial room and patient bedside) were paired side-by-side, and shared a touch sensitive plasma screen capable of high-resolution display and web-based networking. Results: Four integrated classrooms were exhibited at HMS for nearly 200 educators attending the 13-School Consortium and the AAMC Annual Meeting in Boston in the fall of 2004 (“An Expo of Educational Technology”). A case demonstration of asthma with pneumothorax was prepared and demonstrated, using all of the modalities embedded in each room. The case began with participants sitting around a tutorial conference table to discuss a New Pathway paper case. Subsequently the group got up from the table and turned to “meet” their tutorial patient—a simulator that began talking to them from the stretcher located just steps away. After interviewing, examining, and treating their “patient,” the participants returned to the conference table, where they discussed the basic science of the case with the aid of web-based display material (MyCourses). Display adjuncts ranged from gross anatomy (annotated chest radiographs and gross pathologic specimens) to physiologic animation (dynamic diagrams with voice overlay from Human Systems Explorer), to virtual microscopy and pharmacology (identification of cellular receptors and structural material in the bronchial tree). Reactions to the demonstration were very positive. Conclusions: A unified learning environment that integrates multiple components of the medical curriculum can be successfully constructed. Such a platform promises to be a useful setting for providing and testing a range of educational approaches. Acknowledgements: Special thanks to Ron Arky for his support of the expo; Grace Huang, Michael Parker, John Halamka, Peter Weinstock, Emily Spilseth Binstadt, Tania Fatovich, Marisa Brett-Fleegler, Rodney Look, & Liana Stanley-Kappus for serving as expo faculty; Kitt Shaffer, Jason Alvarez, Rick Gillis, & Leanne Dunbar for helping to integrate web-based material into the program; the Office of Student Affairs for their administrative support; Bob Christiano and Paul Barkon for operational assistance; and METI, Inc. for providing simulators and sponsorship for the expo. Conflict of Interest: Authors indicated they have nothing to disclose.