Bedside Teaching Research Articles

Assessment of knowledge and utilization of electrocardiogram by primary health care physicians and nurses in Qassim Region, Saudi Arabia

Objective: This study aimed to assess primary care physicians' and nurses' knowledge and utilization of electrocardiograms (ECG) in primary health care centers (PHCCs) in Qassim, Saudi Arabia. Methods: A cross-sectional study was conducted among PHCC physicians and nurses in Qassim Region, Saudia Arabia. An online self-administered questionnaire was used to obtain information about the knowledge and use of ECG. Results: A total of 320 physicians, family medicine residents, and nurses participated in the survey. Out of the participants, 174 (54.4%) were females. The majority (n=130, 40.6%) were aged between 31 and 40 years. In terms of the number of ECGs requested per week, approximately half of the participants, 158 (49.4%), requested ECGs two to five times per week. The most common reason for ECG requests was angina at 279 (87.2%), followed by arrhythmia at 139 (66.3%) and hypertension at 80 (25.0%). A majority of the doctors (56.3%) reported receiving ECG interpretation from senior colleagues. The most common ECG diagnosis reported was normal ECG among 296 (92.5%). Furthermore, 114 (35.6%) of the participants stated that they believed bedside teaching was the most effective way to improve ECG knowledge and its practical use. Conclusion: This study revealed that primary care physicians and nurses in Qassim, Saudi Arabia, had a limited understanding of and limited use for ECGs. It is strongly recommended to provide bedside training, hands-on tutorials during clinical rotations, and workshops/continuous medical education (CMEs) to enhance ECG knowledge, attitude, and utilization.

Students’ perspective of Simulation Based Clinical Teaching in Surgery Block - an experience at Qassim University, Saudi Arabia

Background and Aims: Due to the lesser availability of patients for bedside teaching, simulation-based teaching sessions were added to enhance clinical skills, and the perspective of the students and their impact on grades attained in clinical skills assessment were analyzed. Methods: Six simulation sessions were conducted using simulated patients and mannequins to cover topics including examination of the abdomen, thyroid, lump, ulcer, rectum, and breast. At the end of the block, a brief, self-designed anonymous questionnaire was used to conduct an online survey to assess the students’ perspective, and the results were analyzed. The clinical skills evaluation results were compared to the grades of students who had previously graduated and received traditional training. Results: The satisfaction level was high, and the majority of students felt that their confidence levels and clinical skills had been enhanced. Various shortcomings in the conduct of simulation sessions were pointed out, and possible solutions were suggested. The grades attained by the students in clinical skills assessment had shown significant improvement. Conclusions: Simulation-based clinical skills teaching is an effective academic tool and has the potential to make up for the deficiencies in traditional bedside teaching.

A Teach-the-Teacher Module for Human Trafficking Bedside Instruction.

Human trafficking (HT) is a public health issue that adversely affects patients' well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT. After piloting the workshop for faculty, fellows, and residents (n = 19) at the Society for Academic Emergency Medicine (SAEM) national conference, we implemented it in medical students' curricula during their emergency medicine clerkship at the University of Iowa (n = 162). We evaluated the worskhop by (a) a retrospective pre-post survey of self-reported ability to (1) define HT, (2) recognize high-risk signs, (3) manage situations with trafficked persons, and (4) teach others about HT, and (b) a 3-month follow-up survey to assess longitudinal behavior change. In both contexts, results demonstrated improvement across all learning outcomes (pre-post differences of 1.5, 1.3, 1.9, and 1.7 on a 4-point Likert-type scale for each learning objective above, respectively, at the SAEM conference and 1.2, 1.0, 1.3, and 1.3 at the University of Iowa; p < .001 for all). In the 3-month follow-up, we observed statistically significant changes in self-reported consideration of and teaching about HT during clinical encounters among learners who had previously never done either (p < .001 and p = .006, respectively). This train-the-trainer module is a brief and effective clinical tool for bedside teaching about HT, especially among people who have never previously considered HT in a clinical context.

Patients’ Perspectives towards Bedside Teaching of Medical Students: an Analytical Cross Sectional Study in Tertiary Care Hospitals

Objective: To determine patients’ perspectives about medical students’ involvement in bedside teachings and its effect on the quality of consultation. Study Design and setting: An analytical cross-sectional study conducted in Combined Military and Pak Emirates Military Hospital Rawalpindi from 1-September-2019, to 1-April-2020. Methodology: Data were collected by convenience sampling using self-structured questionnaire. With a response rate of 91%, sample of 294 from medicine and surgery departments were included who had or not consultations in presence of students, excluding patients with decreased mental functioning. Kruskal-wallis and Mann-Whitney-U tests were applied to compare mean scores considering statistically significant difference at &lt;0.05. Results: Among participants (mean age 30.8 ± 8.51) almost 138(47%) patients thought benefitted interaction with students, 191(65%) expressed disagreement to discomfort during history, which decreased towards discussing sensitive information and examination in absence of senior. Among seven domains of questionnaire, positive attitude towards students and preference of local language received the highest mean score, discomfort during the examination and students’ acceptability received the lowest. A significant difference was found among participants with higher education regarding permission for students’ presence (p-value 0.009). Conclusion: Majority of participants considered students’ interaction beneficial, but shared discomfort feeling during examination. Students’ involvement was considered imperative for their training, thinking that they are serving the community. Participants with high education reflected upon permission prior to encounter and those with less education shared that all discussion in their presence must be in understandable language

Why include Case-based Learning in the medical curriculum? &amp;ndash; A review

Introduction: Clinical teaching is an irreplaceable component of medical education. It takes place through many teaching–learning methodologies in various settings such as the bedside, classrooms, and the community. Case-based Learning is a method which had been devised to fill the gaps seen in bedside teaching where learning is mostly opportunistic. CBL evolves around pre-selected typical cases from an existing collection through small-group discussions.Method: The objective of the study was to identify the positive features of CBL in clinical education. A narrative review was done to search articles on PubMed and Google Scholar between 2018 and 2023. The search terms were ‘case-based learning’ ‘clinical education’ and ‘medical curriculum’.Results: The narrative review identified articles (n=14) relevant to our study. Case-based learning and discussion were seen as an effective and acceptable learning tool by medical students. It helped them to gain clinical reasoning skills which are critical in clinical decision-making and management. Exposure to case-based learning scenarios, allowed them to relate basic sciences to clinical sciences. Students were able to recollect the concepts that they had learnt by correlating them with case scenarios in a stress-free environment enhancing their critical thinking abilities. It promoted collaborative learning skills among students.Conclusion: CBL was perceived as a good learning tool by students. It is possible to combine CBL with other traditional clinical teaching methods such as bedside teaching. The case-based learning approach promotes recapitulating the basic concepts learned, relating them to a clinical scenario that results in the consolidation of the concepts.

Bedside teaching with case based discussions and flipped classroom in undergraduate medical students

Bedside teaching with case based discussions and flipped classroom in undergraduate medical students

An educational model to teach at the bedside: A qualitative exploratory descriptive study

Background: Teaching medical students at the bedside to foster a spectrum of essential skills can only be acquired if an educational method is utilized in rounding practices regularly. Therefore, this study aimed to identify the best model for conducting bedside rounds from the perspectives of medical teachers and students in our context. Methods: This qualitative exploratory descriptive study, using interviews and observations, was conducted at the Kerman University of Medical Sciences, Iran in 2020. We recruited skilled bedside teachers/role models (n=6) and medical students (n=8) based on snowball and purposive sampling techniques. Data were collected through (A) semi-structured individual interviews and (B) observation of clinical rounds. We used deductive content analysis to analyze data using MAXQDA software version 12. The trustworthiness of the data was evaluated based on four criteria: credibility, transferability, dependability, and confirmability. Results: In total, this study involved 14 participants, which included 6 bedside role models and 8 medical students. The mean age of medical teachers and medical students was 50 and 29.6 years, respectively. The mean duration of the interviews for medical teachers, medical students, interns, and residents was 20, 25, 30, and 20 minutes, respectively. The findings revealed three cycles and twelve phases that contribute to the development of the optimal bedside teaching model. These include the preparation cycle (comprising preparation, planning, and orientation), the clinical exposure cycle (which involves introduction, interaction, instruction, reinforcement, supervision, and summarization), and the conclusion cycle (consisting of debriefing, feedback, and reflection). Conclusion: An educational model can better facilitate the acquisition of the entire range of clinical skills and professional behaviors, which are indispensable components of learning. The experiences obtained from batches of participants in our context have been instrumental in developing an essential model that fosters both tangible and intangible skills, thereby producing competent doctors.

Structure and quality of bedside teaching: A videographic analysis

Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife’s competency in performing cesarean section in Ethiopia: a quasi-experimental study

BackgroundSimulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives’ competency in Ethiopia.MethodsA quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020.ResultThe age of the respondents varies from 24 to 34 years, with the control group’s mean age being 28.8 (± 2.3) years and the intervention group’s mean age being 27.2 (± 2.01) years. The intervention and control groups’ pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these.ConclusionsThe study showed that simulation-based education improved students’ procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.

A training program for obstetrics point-of-care ultrasound to 514 rural healthcare providers in Kenya

BackgroundUltrasound is a crucial and effective diagnostic tool in medicine. Recent advancements in technology have led to increased use of point-of-care ultrasound (POCUS). Access to ultrasound equipment and training programs in low-and middle-income countries (LMICs) is limited. Despite the World Health Organization (WHO) recommendations for universal antenatal ultrasounds, POCUS for reproductive health applications has not been widely used in LMICs. We describe here the feasibility of implementation of a training of obstetrics point-of-care ultrasound (OB POCUS) for high-risk conditions in rural public healthcare facilities in Kenya with partnership from Butterfly Network, Global Ultrasound Institute, and Kenyatta University.MethodsAs part of the initiation of a large-scale implementation study of OB POCUS, clinician trainees were recruited from rural Kenyan hospitals for participation in a series of five-day POCUS workshops held between September and December 2022. Trainers provided brief didactic lessons followed by hands-on training with live models and at regional clinical sites for 5 OB POCUS applications. Instructor-observed assessment of students’ scanning and image interpretation occurred over the training period. Assessment of knowledge and confidence was performed via an online pre-test and post-test as well as Objective Structured Clinical Examination (OSCE) was administered at course completion.ResultsFive hundred and fourteen mid-level Health Care Providers (HCPs) in Kenya were trained over a three-month period through in-person didactic sessions, bedside instruction, and clinical practice over a 5-day period with a trainer: trainee ratio of approximately 1:5. Out of the 514 trained HCPs, 468 were from 8 rural counties with poor maternal and neonatal outcomes, while the remaining 46 were from nearby facilities. OB POCUS topics covered included: malpresentation, multiple gestation, fetal cardiac activity, abnormalities of the placenta and amniotic fluid volume. There was marked improvement in the post training test scores compared to the pretest scores.ConclusionOur implementation description serves as a guide for successful rapid dissemination of OB POCUS training for mid-level providers. Our experience demonstrates the feasibility of a short intensive POCUS training to rapidly establish specific POCUS skills in efforts to rapidly scale POCUS access and services. There is a widespread need for expanding access to ultrasound in pregnancy through accessible OB POCUS training programs. An implementation study is currently underway to assess the patient and systems-level impact of the training.

BEDSIDE LEARNING: VITAL FOR NURSING EDUCATION - CREATING COMPETENT, EMPATHETIC HEALTHCARE PROFESSIONAL

This comprehensive review explores the vital role of bedside learning in nursing education, focusing on its impact on clinical skill development and empathy among students. By bridging theoretical knowledge with practical application, bedside teaching allows nursing students to apply classroom concepts directly to patient care, enhancing understanding and retention. The review highlights evidence-based practice (EBP) teaching strategies and emphasizes the need for improved interactive and clinically integrated approaches.. It cultivates empathy and compassion as students interact with patients personally, witnessing their struggles and hopes. Furthermore, bedside learning enhances communication skills, enabling students to establish meaningful connections with patients and healthcare teams. Finally, this method promotes critical thinking by challenging students to analyze patient cases and make informed decisions. Conclusion:In conclusion, research highlights the pivotal role of bedside teaching in clinical education, especially in nursing. Hands-on experiences and patient interactions are essential for developing clinical reasoning skills, fostering patient-centered care, and nurturing professional growth. Conflict of Interest: There is no conflict of interest.

Perception of Undergraduate Students about Bedside Teaching: Experience at a Private Medical College

Introduction: Bedside teaching is an essential tool for clinical skill demonstration in undergraduate medical education. Recently, a shift away from bedside teaching has been seen, which can lead to a decline in students' clinical performance.Objective: To understand the student perception of bedside teaching among undergraduate medical students in their fourth and final year of MBBS.Methods: A cross-sectional study was done using an online Google form of a validated questionnaire after getting permission from authors from 4th and 5th-year MBBS students of Sharif Medical and Dental College, Lahore, in March 2023. The questionnaire tested the four domains, which included the physical environment and the patient’s comfort and attitude toward the patient, the teaching task of the teacher, and group dynamics. Each domain has further 5, 7, 9, and 4 questions using a Likert scale ranging from strongly agree to strongly disagree. Results: The age range of the participants was between 20 and 25. The response rate was 90% for 4th year and 93 % for the final year. The adequacy of the space and the noisy place were barriers in the physical environment. Patient comfort, attitude toward the patient, and bedside teaching ethics were followed adequately. Conclusion: Bedside teaching is an important skill to enhance clinical skill practice, communication skills, and management skills. The decline in bedside teaching can compromise patient management skills for future doctors. Appropriate steps should be taken to rectify the barriers to adequate provision of BST.&#x0D;

Declining bedside teaching: the need for African medical institutions to adopt a structured approach.

Dear Editor, Bedside teaching or ward rounds teaching has for many years been a major component of medical education but its use is currently on the downward trend in several medical institutions. The causes of this decline are diverse including busier hospitals with limited time allocation to complete each day's tasks. This reality calls for innovative ways to make bedside teaching more effective within time constraints. [...]

What’s art got to do with it?—Transfer of learning in museum-based health professions education

Museum-based education for health professionals is a rich and expanding field in which educators engage health professions learners in arts-based activities intentionally designed to support transfer of learning from a museum to a clinical context. Museum-based education for health professionals promotes several key learning outcomes including: mastery of core skills such as observation, interpretation, and communication; cultivating personal insight; fostering appreciation for multiple perspectives; opening avenues to explore social advocacy; and promoting wellness. Following a museum-based activity, translational facilitators guide learners through a debriefing process which supports the discovery of real-world connections to clinical teaching, learning, and care delivery. Translational debriefing involves practices such as attending to psychological safety, using reflective listening and open-ended questions, practicing cultural humility, maintaining neutrality, and modeling curiosity. These translational opportunities can also help participants who are themselves health professions educators gain insights into their own teaching practices and provide new tools to incorporate, including bedside teaching strategies and innovative ways to facilitate small group learning.

Pediatric Emergency Medicine Fellow Training for Bedside Teaching: A National Survey of Pediatric Emergency Medicine Fellows and Program Directors

Pediatric Emergency Medicine Fellow Training for Bedside Teaching: A National Survey of Pediatric Emergency Medicine Fellows and Program Directors

Bedside teaching in optometry: A millennial view on an ancient teaching and learning method

Bedside teaching in optometry: A millennial view on an ancient teaching and learning method

Patients' attitudes to bedside teaching after the COVID-19 pandemic.

Bedside teaching (BST) is a method of structured clinical teaching where the patient is central in education. We had previously explored the patients' perceptions of BST using both a qualitative research study and validation of a questionnaire, both showing strong support by patients for BST once basic rules of respect and confidentiality are followed. With the COVID-19 pandemic, clinical education transitioned to online/virtual learning. The aim of this study was to explore patients' attitudes towards reintroduction of BST as the pandemic restrictions have lifted. Patients were invited to complete a validated questionnaire exploring their attitudes towards BST. A descriptive analysis was performed. Results were compared to a previous study performed before the COVID-19 pandemic. Four hundred patients consented to complete the questionnaires. Participants included women attending for antenatal (40%), postnatal (33%) and gynaecology issues (28%). Most patients (> 94%) reported that they were happy to be involved in BST. Patients believed that they should not be asked to participate in BST should they feel stressed or unwell (69%). These findings were the same as our previous study, performed prior to the pandemic. This study shows extensive and persisting patient support for BST. BST is unique in that it allows students to gain a deeper understanding of the disease which are hard to elicit through online/virtual methods.

Anton de Haen (1704-1776) and his extraordinary "portentosum infundibulum" case: the futile skull cauterization of a blind patient with a craniopharyngioma.

Anton de Haen (1704-1776) became one of the most influential physicians in the Habsburg Empire as a reformer of clinical instruction at Vienna Citizen's Hospital (Bürgerspital), where he introduced the bedside teaching method he had learned from Herman Boerhaave in Leyden, Holland. He also promoted the meticulous recording of clinical observations and the use of postmortem studies to identify the cause of death in hospitalized patients. Among the numerous clinicopathological reports compiled in his monumental 18-volume work Rationis Medendi in Nosocomio Practico, published in 1761, was the first documented patient with amenorrhea caused by a pituitary tumor, appearing in the 6th volume. This 20-year-old amaurotic woman, who had suffered from chronic excruciating headache, died after the unsuccessful application of a cauterizing iron to her temporal bone. At the autopsy, a large solid-cystic and calcified tumor with gross characteristics typical of adamantinomatous craniopharyngioma was found encroaching on the infundibulum and third ventricle. This is the first known account of an infundibulo-tuberal lesion associated with the impairment of sexual functions, predating by 140 years the pathological evidence for a sexual brain center sited at the basal hypothalamus. In this paper, the authors analyze the historical importance and impact of de Haen's foundational report on the fields of neuroendocrinology and neurosurgery.

A41Implementation of virtual clinical experiences for Myanmar medical students: a pilot rollout of remote-synchronous simulation

Severe disruptions have plagued Myanmar’s undergraduate and postgraduate medical education – firstly with the Covid-19 pandemic and later with a military coup d’état in February 2021. In the wake of the current humanitarian and political crisis, many medical students partaking in civil disobedience have been driven underground for fear of retribution. Foregoing bedside teaching and crucial clinical learning opportunities in hospitals – for online education through teleconferencing and live broadcast via social media. To scale up these efforts the Global Health Education Group’s (GHEG) novel XR platform was piloted to provide remote clinical experiences streamed to Myanmar students with the help of diaspora doctors and virtual patients in the UK [1]. The pilot held over a 4-day period in February comprised 4 Virtual Clinical Experience (VCE) sessions each covering two simulated patient scenarios related to the following disciplines: Medicine, Surgery, Obstetrics and Gynaecology, and Paediatrics. Each session had an introductory, consultation, and debrief phase that ran for 1.5 – 2 hours altogether. This was held on GHEG’s newly developed Virtual CP platform [2], which enabled the students to view a live stream of the consultation with the patient-actor through the clinician’s smart glasses and provided the opportunity for real-time interaction. The sessions were successfully delivered to 400 students from across 5 Myanmar Universities. The student’s satisfaction was assessed using an anonymous feedback form that was disseminated; a total of 38 responses was obtained which was overwhelmingly positive. 76.3% of the respondents rated the session to be ‘helpful’ or ‘extremely helpful’ and 68.4% rated the session to be representative of a real clinical experience. On a scale out of 10, 57.8% of respondents rated the VCE platform a 6 and above on ease of use. Technical difficulties did arise affecting 68.4% of respondents, although free text feedback purported they were promptly addressed in subsequent sessions. Synchronous remote learning through virtual clinical experiences can be used to address the dearth of clinical opportunities afforded to medical students in Myanmar. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A comparison of curricula at various medical schools across the world.

B a c k g r o u n d: Medical education has changed in response to scientific advances and social needs. A i m: The aim of the study was to examine curricula of medical schools around the world and to observe the trends that currently dominate in medical education. M e t h o d: We have collected information on the current curricula of various medical schools using their official websites. When necessary, we supplemented the information using published articles describing the curriculum of a given medical school. R e s u l t s: Our findings reveal that medical schools demonstrate the need for constant reforms and adaptation to changing conditions worldwide. Generally, there is a tendency to integrate basic and clinical fields, to sooner establish bedside teaching, to provide less theoretical and more practical approaches to teaching, to implement more communication skills, and provide students with research training. C o n c l u s i o n s: Medical education has evolved and will continue to change with time. Medical schools introduce modifications to their curricula and share their experiences.