Bedside Teaching Sessions Research Articles

Peer-to-peer clinical teaching by medical students in the formal curriculum

Introduction: Medical students have long provided informal, structured academic support for their peers in parallel with the institution’s formal curriculum, demonstrating a high degree of motivation and engagement for peer teaching. This qualitative descriptive study aimed to examine the perspectives of participants in a pilot peer teaching programme on the effectiveness and feasibility of adapting existing student-initiated peer bedside teaching into formal bedside teaching. Methods: Study participants were senior medical students who were already providing self-initiated peer-led bedside clinical teaching, clinicians who co-taught bedside clinical skills teaching sessions with the peer teachers and junior students allocated to the bedside teaching sessions led by peer teachers. Qualitative data were gathered via evaluation form, peer teacher and clinician interviews, as well as the observational field notes made by the research assistant who attended the teaching sessions as an independent observer. Additionally, a single Likert-scale question on the evaluation form was used to rate teaching effectiveness. Results: All three peer teachers, three clinicians and 12 students completed the interviews and/or questionnaires. The main themes identified were teaching effectiveness, teaching competency and feasibility. Teaching effectiveness related to the creation of a positive learning environment and a tailored approach. Teaching competency reflected confidence or doubts about peer-teaching, and feasibility subthemes comprised barriers and facilitators. Conclusion: Students perceived peer teaching effectiveness to be comparable to clinicians’ teaching. Clinical peer teaching in the formal curriculum may be most feasible in a hybrid curriculum that includes both peer teaching and clinician-led teaching with structured training and coordinated timetabling. Keywords: Peer Teaching, Undergraduate Medical Education, Bedside Teaching, Medical Students

BLENDED LEARNING APPROACH PROMOTES THE APPLICATIONIN ORTHOPEDICS, A MIXED PROSPECTIVE STUDY

Objectives: Blended learning is a combination of online and face-to-face teaching. The current study aimed to assess the impact of a blended approach on perceptionsand achievements in orthopedics. Methods: The online component of the developed blended course comprises lectures, discussion forums, demonstrative videos, scenarios, discussion panels, and illustrated atlases. In college, activities included hands-on and bedside teaching sessions. Hybrid activities such as team-based learning, case-based learning, and seminars were included. Case discussions and roleplays were conducted as assignments. Students perceptions were identified through the survey and focus groups, while tutors opinions were expressed through personal interviews. A comparison between students achievements after the blending and that of the previous year taught in traditional form was carried out. Results: A high degree of student satisfaction, enthusiasm, and interest in the blended course was identified students recommended its use in other courses and showed appreciation for how the tutors conducted it. Tutors revealed acceptance towards blending and suggested some modifications. There was a significant improvement in students achievements in the Objective-structured-practical and Objective-structured-clinical examinations (p= 0.0005 and 0.0011) compared to the previous year, with no difference in MCQ achievements. Conclusion: It can be concluded that the blended approach enhanced students skills and enthusiasm in orthopedics.

Student mistakes and teacher reactions in bedside teaching

We analyse interactions between teachers and students during video-recorded bedside teaching sessions in internal medicine, orthopaedics and neurology. Multiple raters used a high-inference categorical scheme on 36 sessions. Our research questions concern the types of student mistakes, clinical teachers’ reactions to them and if they use different strategies to address different types of mistakes. We used a Poisson model and generalized mixed models to analyse these research questions. Most frequently, students made reproduction mistakes. Relatively high rates of rejection and a similar prevalence of low and high levels of elaboration and correction time for students were observed. Reproduction mistakes were associated with the highest level of rejection and the lowest level of elaboration. High levels of elaboration were observed when students were applying skills in new situations. Students were most often allowed time to correct when mistakes in the areas of analysis or application of skills and knowledge had occurred. There is a decrease in the rate of making mistakes for neurology and orthopaedics compared to internal medicine. Reproduction mistakes influence significantly the outcome feedback compared to application mistakes. Analytic and reproduction mistakes influence elaboration significantly compared to application mistakes. We found a significant effect whether the lecturer allows time for correction of reproduction mistakes compared to application mistakes. These results contribute to the understanding of interactive, patient-centred clinical teaching as well as student mistakes and how teachers are reacting to them. Our descriptive findings provide an empirical basis for clinical teachers to react to student mistakes in didactically fruitful ways.

Instructional Strategies in Bedside Teaching Sessions in Public Sector Hospitals in Iraq

Bedside teaching is an effective and commonly used teaching method in medical education. However, few studies have analyzed the language and instructional strategies used during real-life interactions in bedside teaching sessions. Past research investigated the effectiveness of bedside teaching methods from medical instructors’ and students’ perspectives and the influences of the relationships between instructors and students on the success of this teaching method. This study sheds light on the discourse of bedside teaching in Iraqi hospitals from a linguistic perspective. The data were collected qualitatively in the form of 26 video recordings of medical instructors and medical students in interactions in two public hospitals in the Kurdistan region of Iraq during bedside teaching sessions and were analyzed in a mixed method technique. Discourse analysis was the research design and Nilsson et al. (2010) classification for instructional strategies was used as the analytical framework of the study. The findings revealed that seven instructional strategies associated with various pragmatic functions were employed by the instructors. The findings imply that the use of proper and effective instructional strategies that suit communicative medical events would have an impact on the understanding, expectations, and situational needs of medical students. The findings have pedagogical implications relevant to the fields of medical education and applied linguistics. This study represents a pioneering attempt to analyze bedside teaching sessions in an Iraqi context. It could therefore form a basis and starting point for future research in the fields of medical education and applied linguistics.

Association Between Level of Knowledge Gained, Confidence, Motivation and Flexibility on Types of Learning for Bedside Teaching Among Clinical Students in Four Malaysian Medical Schools During COVID-19 Pandemic

Introduction: With the arise of the COVID-19 pandemic, higher institutions are forced to change the method of delivery for bedside teaching sessions from face-to-face to online learning. However, online learning was found not effective in delivering practical knowledge and skills to students. Hence, the objective of this study was to determine the association between level of knowledge gained, confidence, motivation and flexibility on types of learning for bedside teaching sessions among clinical students in four Malaysian medical schools during COVID-19 pandemic. Methods: A cross-sectional study involving medical students from Universiti Putra Malaysia (UPM), Universiti Sains Islam Malaysia (USIM), Universiti Islam Antarabangsa (UIA) and Universiti Sains Malaysia (USM) were conducted from 1st March 2021 until 6th June 2021. An online questionnaire was distributed and it consisted of 5 sections which cover sociodemographic information, level of knowledge gained, confidence, motivation, and flexibility from bedside teaching session. The data was analysed by using SPSS software program. Results: There is a significant association between the level of knowledge gained, level of confidence, level of motivation and level of flexibility with the type of learning (online or face-to-face) during bedside teaching sessions. Results revealed that students gained a higher level of knowledge (84.9%), higher level of confidence in physical examination (93.3%), higher motivation (82.2%) and higher flexibility (64.1%) during face-to-face bedside teaching sessions compared to online learning. Conclusion: Most of the medical students in four Malaysian medical schools prefer face-to-face learning compared to online learning for bedside teaching sessions.

Getting to know you: implementing an interprofessional education program for medical and respiratory therapy students in mechanical ventilation – challenges and lessons learned

ABSTRACT The physician and respiratory therapist function as an interprofessional team caring for patients on mechanical ventilation. There is a paucity of research devoted to interprofessional education (IPE) of students from different professions in mechanical ventilation during clinical rotations in the medical intensive care unit (MICU). Student interprofessional education could develop team communication and shared decision-making skills early in training. The uniqueness of this introductory IPE programme is that it occurs during a clinical rotation in a real MICU, as opposed to a pre-clinical simulated campus setting, and it blends students from various educational backgrounds. Medical students and respiratory therapy students from different academic institutions participated in traditional lectures, small interprofessional group case-based problem-solving sessions, MICU bedside teaching sessions, written assessments, and focus groups. Quantitative responses were analyzed using descriptive statistics. Qualitative responses were categorised using the core competencies for Interprofessional Collaborative Practice. The purpose of this introductory IPE programme was to foster opportunities for interprofessional interaction during the student clinical experience while improving knowledge about mechanical ventilation. Qualitative expectations and feedback were predominantly positive. Quantitative responses suggest that students from both disciplines gained knowledge about mechanical ventilation in an IPE setting.

New York University Grossman School of Medicine.

New York University Grossman School of Medicine.

Increasing Neonatal Healthcare Productivity using Clinical Reasoning Coaching Tools

Introduction: Productivity in medical field has inherent value in terms of improving our lives, which can expand our economies. Productivity in medicine has many aspects including improving clinical diagnostic skills, safety, and quality and quantity care. This study will assess whether early exposure to structured clinical reasoning coaching tools would improve their clinical decision making and productivity. Research question: Does clinical reasoning coaching tools Increase neonatal healthcare productivity? Materials and method: Medical practitioners recently joined neonatal units will participate over 2 years in an innovative series of clinical reasoning coaching sessions blended with virtual patients. Practitioners will be exposed to many teaching methods during the neonatal training that includes lectures, bedside teaching sessions and small group discussions beside website continuous contact for learning and chairing skills. Teaching series scope should cover resuscitating sick neonates, handling ventilators either conventional or high frequency, practicing common neonatal procedures, dealing with common neonatal scenarios, infection control policy and, effective communication skills The evaluation sessions will be introduced at the beginning of their training, during the course and at the end of the clerkship to assess their improving productivity, using diagnostic thinking inventory(DTI). Selection of the medical practitioners will be based on either on stratified random sampling or cohort control depending on the funding and logistic. All items will be analysed advanced statistical analysis methods. Results: The coaching tool may yield dramatic impact, allowing the innovators to be more productive. Suggesting widely utilize it for nurses, undergraduate and postgraduate medical Subspecialty. Conclusion: The research hypothesis is assuming that DTI scores and productivity will be higher after the coaching sessions as rated by the candidate’s performance.

Parents' perceptions of bedside teaching.

Bedside teaching (BST) in a hospital setting can play an important role during medical students' clinical placements in paediatrics. Parents often feel obliged to allow their child to participate, even if they are reluctant. The aim of this study was to examine the perceptions of parents who, with their children, were involved in medical students' BST. Consenting parents participated in a semi-structured interview assessing their experience of having their child involved in BST. The qualitative data were analysed using thematic analysis. Parents were assured that their children's treatment would not be negatively affected in the case of withdrawal from the study. A total of 54 parents responded and discussed their experience of their children's participation in clinical teaching. The majority of parents were keen to support medical students' learning, and felt that they could develop better insight into their child's health in association with the teaching session. Some parents found the sessions tiring; their interest increased when they were more actively involved in planning the BST sessions. This study emphasises children's and adolescents' autonomy as a main principle in making decisions about involving them in BST. Clinical teachers often face problems attempting to properly plan and conduct BST sessions. Parents appreciate having an active role in planning the sessions and are supportive of medical student education. Clinical teachers must ensure that they protect the best interests of paediatric patients and their parents. At the same time, they should advocate for the obvious benefits of BST.

Knowledge and Skills of Medical Students about Stroke Patients: A Review

Stroke, a leading cause of neurological disability in the world, is the third major reason for mortality after cancer and heart diseases. It is an epidemic emerging worldwide, especially in the low and middle-income countries. Most of the patients survived from stroke are not treated completely and have a life with disability and complications. Therefore, it is necessary that medical students be trained and educate in a standardized manner through focused lectures, interactive workshops, and bedside teaching sessions so that they can deal with these patients and manage potentially disabling neurological emergencies such as stroke correctly.

Students' opinions on the prevailing and innovative methods in medical education technology and changes recommended

Background: Medical education technology has evolved greatly and it is essential to keep abreast of the recent techniques to keep the students focussed in the classroom. It is also necessary to receive feedback and input from the students regarding our teaching methodologies. Our aim was to learn from the learners about their opinion regarding the current teaching methodology. Methods: 172 students belonging to two batches participated in the study. 79.83% of the students were satisfied with the current system. A questionnaire was prepared with 23 questions covering the current methodology, innovations, learning methods and faculty qualities. Results: 77.70% of the students opined that the present system of medical teaching in pharmacology was satisfactory. 40% of the students thought that interactive sessions are desirable. 52.8% students said that was that seminars can be fun once in a while with 21.35% saying that only the group leaders benefit from seminars. 60.8% said bedside teaching sessions were interesting and useful. 52.67% students thought that problem-based learning (PBL) could be interesting and 21.5% thought it is essential. Conclusions: The survey reveals that the students are satisfied with the current system on the whole. However they require changes in some areas like lectures and seminars. They appear willing and enthusiastic to accept new concepts in teaching. Hence, newer teaching-learning methodologies should be tried and adopted for better classroom results.

Bedside Teaching: The Meeting-to-Meeting Model

The Meeting-to-Meeting Model is designed to provide a medical educator with an easy-to-use guide to conduct efficient bedside teaching sessions in inpatient settings. Here, we summarize some of the strategies described in the literature, which we have modified in order to make the model more practical. The model comprises five main steps: Meeting I, corridor I, patient encounter, corridor II, and meeting II. We also briefly describe adult learning theory in relation to BST. Further research is needed to assess the generalizability of the model and to evaluate its effect on educational outcomes.

G121(P) Transition from pressure to volume control ventilation in a tertiary level neonatal unit – a quality improvement project

Background and aim Evidence suggests that volume targeted ventilation improves short-term outcomes in preterm infants.1 Change of practice to using volume targeted ventilation as the default mode was instituted at...

Modified case based learning: Our experience with a new module for pharmacology undergraduate teaching.

Objective:The undergraduate teaching in pharmacology has always been a challenging task for medical teachers. Traditional lecture format is monotonous and a passive way of learning. There is a need to shift the educational focus from content centered to case based. In an effort to create interest and further improve the student learning, we have introduced simulated bedside teaching sessions as case based learning (CBL) module (modified CBL-[mCBL]) for 2nd professional MBBS students.Materials and Methods:A case scenario of a clinical disease condition was prepared in consultation with a clinician. During the session, the case was presented along with discussion on the disease process, its management and rational drug use. Students were encouraged to participate actively. After the session, students were requested to fill the feedback questionnaire anonymously (both open-ended questions and responses on Likert scale).Results:According to the students, factors such as clinical orientation, interactivity and re-enforcement of important points helped them to learn better. Majority of the students (76.09%) found the sessions to be better than theory lectures and tutorials. The fact that the interactive component of departmental feedback (taken at the institutional level) has improved during the last 2 years could be attributed to the introduction of these sessions.Conclusion:mCBL (in the presence of departmental faculty and concerned clinician) is a good method of integrating pharmacology with clinical subjects. To make such sessions more reliable, the next planned step is to assess the knowledge gained by the students during such sessions in the future.

Knowledge and Skills Competencies for the Undergraduate Internal Medicine Curriculum in Saudi Arabia

OPEN ACCESSNovember 15, 2010Knowledge and Skills Competencies for the Undergraduate Internal Medicine Curriculum in Saudi Arabia Hani Almoallim, MD Hani Almoallim, MD Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.8177 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstractThis resource contains all of the research used to reconstruct the internal medicine curriculum in at Umm Alqura University in Saudi Arabia. This research can also assist in designing a national guide for internal medicine teaching in medical colleges of Saudi Arabia. It also can be used in designing a clerkship curriculum in internal medicine based on these specified competencies that augment and serve as a continuum of what had been taught in undergraduate curriculum. In this national research project, the knowledge and skills competencies in internal medicine for the undergraduate curriculum were determined and prioritized following a strict research methodology. A group of 20 clinicians rated the identified competencies from 0–3 (0: no need to know, 1: Interesting to Know, 2: Should Know and 3: Must Know). A total of 1514 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to 12 systems in internal medicine. This resource was used along with other work from different disciplines, at the institution to design an integrated curriculum where basic scientists and clinicians are sharing the same responsibilities in teaching medicine. This approach will greatly enhance the relevancy of the taught materials to the needs of medical students. The use of this resource should help in determining and specifying clear competencies for courses, curricula, lectures, problem-based learning, and bedside teaching sessions. It can also assist in the design of integrated curriculum that will greatly enhance the relevancy of the taught materials to the needs of medical students. Educational Objectives By the end of this module, the learner will be able to: Determine and prioritize competencies for the undergraduate internal medicine curriculum.Differentiate between important and less important components of undergraduate internal medicine curriculum.Design efficient undergraduate internal medicine curriculum based on clearly identified competencies.Improve quality of teaching of internal medicine by focusing on objectively defined knowledge and skills competencies. ReferencesShumway J.M. and Harden R.M., AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Med Teach, 2003. 25(6): p. 569–84. http://dx.doi.org/10.1080/0142159032000151907Medline, Google ScholarReid N., The Delphi Technique: It's Contribution to the Evaluation of Professional practice. Professional Competence and Quality Assurance in the Caring Professions, ed. Ellis R.. 1988, New York: Chapman Hall.Google Scholarde Villiers MR, de Villiers PJ, and Kent AP, The Delphi technique in health sciences education research. Med Teach, 2005. 27(7): p. 639–43. http://dx.doi.org/10.1080/13611260500069947Medline, Google ScholarMyers A.R., NMS Medicine. 2005: Lippincott Williams & Wilkins.Google ScholarTalley NJ, O'Connor S. Clinical Examination. 2005: Wiley-Blackwell.Google ScholarLawrence PF, et al., Determining the content of a surgical curriculum. Surgery. 1983;94(2):309–317.Medline, Google ScholarGoroll AH, et al. Reforming the core clerkship in internal medicine: the SGIM/CDIM Project. Society of General Internal Medicine/Clerkship Directors in Internal Medicine. Ann Intern Med.2001;134(1):30–37. http://dx.doi.org/10.7326/0003-4819-134-1-200101020-00011Medline, Google ScholarBass EB, et al. National survey of Clerkship Directors in Internal Medicine on the competencies that should be addressed in the medicine core clerkship. Am J Med.1997;102(6):564–571. http://dx.doi.org/10.1016/S0002-9343(97)00054-5Medline, Google Scholar Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.docx Diseases Based Ratings [1][1].pdf All competencies 1 of 4 Sheet (0-3)[1].pdf Core Competencies 1 of 4 Sheet (2.2-3)[1].pdf To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2010 Almoallim. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.KeywordsPBLKnowledge CompetenciesDelphi TechniqueCompetency-Based Education Disclosures None to report. Funding/Support None to report. Loading ...

University of Washington School of Medicine

University of Washington School of Medicine

Effects of “minimally invasive curricular surgery” – A pilot intervention study to improve the quality of bedside teaching in medical education

Background: Bedside teaching is an important element of undergraduate medical education. However, the impact of curricular course structure on student outcome needs to be determined.Aims: This study assessed changes in fourth-year medical students’ evaluations of clinical teaching sessions before and after the introduction of a new course format.Method: The curricular structure of bedside teaching sessions in cardiology was modified without changing the amount of teaching time. Clinical teachers were instructed about the new teaching format and learning objectives. The new format implemented for adult but not paediatric cardiology sessions was piloted with 143 students in winter 2007/08. By computing effect sizes, evaluation results were compared to data obtained from 185 students before the intervention.Results: Significant rating increases were observed for adult cardiology teaching sessions (Cohen's d = 0.66) but not paediatric cardiology sessions (d = 0.22). In addition to improving the structure and organization of the course, the intervention significantly impacted on students’ perceptions of their learning outcome regarding practical skills (d = 0.69).Conclusions: Minimal curricular changes combined with basic faculty development measures significantly increase students’ perception of learning outcome. Curricular structure needs to be considered when planning bedside teaching sessions in medical undergraduate training.

Teaching cardiac examination skills

To determine if structured teaching of bedside cardiac examination skills improves medical residents' examination technique and their identification of key clinical findings. Firm-based single-blinded controlled trial. Inpatient service at a university-affiliated public teaching hospital. Eighty Internal Medicine residents. The study assessed 2 intervention groups that received 3-hour bedside teaching sessions during their 4-week rotation using either: (1) a traditional teaching method, "demonstration and practice" (DP) (n=26) or (2) an innovative method, "collaborative discovery" (CD) (n=24). The control group received their usual ward teaching sessions (n=25). The main outcome measures were scores on examination technique and correct identification of key clinical findings on an objective structured clinical examination (OSCE). All 3 groups had similar scores for both their examination technique and identification of key findings in the preintervention OSCE. After teaching, both intervention groups significantly improved their technical examination skills compared with the control group. The increase was 10% (95% confidence interval [CI] 4% to 17%) for CD versus control and 12% (95% CI 6% to 19%) for DP versus control (both P<.005) equivalent to an additional 3 to 4 examination skills being correctly performed. Improvement in key findings was limited to a 5% (95% CI 2% to 9%) increase for the CD teaching method, CD versus control P=.046, equivalent to the identification of an additional 2 key clinical findings. Both programs of bedside teaching increase the technical examination skills of residents but improvements in the identification of key clinical findings were modest and only demonstrated with a new method of teaching.