TEACHING AT THE BEDSIDE
By the end of this module, you will be able to:
- Identify challenges associated with teaching at the bedside.
- Utilize resources to help you prepare to teach at the bedside.
- Verify basic skills with your medical students early in their rotation.
- Identify and implement behaviors that reflect respect of patients.
- Discuss the importance of role modeling through your teaching.
- Apply a general organizational framework to your bedside teaching.
The concept of teaching at the bedside is the most elemental way to teach medicine while also being one of the most complex. As a teaching and learning opportunity, the patient is CENTRAL to this type of teaching and the information discussed revolves around the care process for this individual. As stated by William Osler in his address to the New York Academy of Medicine in 1903,
It is a safe rule to have no teaching without a patient for a text, and the best teaching is that taught by the patient himself.
However, this fundamental context can be particularly challenging as a teaching context because it involves multiple, simultaneous relationships. At its most basic level, these include: resident-learner; resident-patient; and learner-patient, each of which can profoundly affect the educational encounter and the educational outcome.
These relationships can be further influenced by the particular attending, as well as other team members. Additional issues adding to the complexity of the context include: the need to provide quality care, time constraints, the nature of the patient's illness, rapid patient turnover, and increasing reliance on ancillary testing. Together, these make for a challenging context in which to teach.