“ Medicine is learned by the bedside and not in the classroom.” Sir William Osler

“Medicine is learned by the bedsideand not in the classroom.”

Sir William Osler

Crumlish CM, et al. Quantification of Bedside Teaching by an Academic Hospitalist Group. J Hospital Medicine 2009; 4:304-7.

82%

of residents want MORE

94%

“bedside teaching timeis valuable”

Bedside Teaching

Sameer D. Khatri, M.D.

Faculty Development Fellow

Take home points

• Everyone has something to offer

• Make a road map

• Stay attentive and be flexible

Learning objectives

• List obstacles to bedside teaching

• Identify advantages

• Try out models for bedside teaching

• Discuss ways to overcome obstacles

• Plan integrating into rounds

Who learns on rounds?Read 10%

Hear 20%

See 30%

See & Hear 50%

Say & Write 70%

Do 90%

Dale, E. Audiovisual Methods in Teaching, 1969, NY: Dryden

So what’s stopping us???

•List obstacles to performing bedside rounds

Barriers from the survey

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

•Describe the advantagesto bedside rounds

What do people value about clinical bedside teaching?• See/teach PE skills

and provide immediate feedback

• Demonstrate professionalism / teach art of medicine

• Get patients involved

• Clarify patient issues

• Pt-centered care

• PE teaching

• Interpersonal skills

• Communication skills

• Integrating clinical exam w/ dx & mgmt decisions

Crumlish CM, et al. 2009MAMC FM, 2012

How can we do it?

• Follow a 12-step model

• Follow a 3-domain model

• Make up our own model

Road maps and focused teaching

• Pick one model

• Pick a real case

• Work through the steps

Take 15 minutes

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• Structured time

• Targeted learning points

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move!

• Make it a part of your everyday routine

• Worth the effort

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Focus on key learning points

• Brush up on skills likely to be covered

• Patient discomfort

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Ask for permission in advance

• Team introduction / get patient involved

• Availability of patients

Overcoming obstacles

• Lack of time / not efficient use of time

• More effort – have to get up and move

• Difficult to fully prepare

• Patient discomfort

• Availability of patients

• Be flexible

Strategies to increaseBedside Teaching

See handout

Taking it to the Ward

What can we commit to now?

Learning objectives

• Listed obstacles to bedside teaching

• Identified advantages

• Tried out models for bedside teaching

• Found ways to overcome obstacles

• Planned integration into rounds

Take home points

• Everyone has something to offer

• Make a road map and follow it

• Stay attentive and flexible

Questions&

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