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How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures
Anna-Lena Blaschke1, Hannah P K Rubisch2, Ann-Kathrin Schindler3
1TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany. annalena.blaschke@tum.de.
Bedside teaching (BST) is a traditional medical education format. Analysis shows most time is spent away from patients, with history taking at bedside, but clinical reasoning and exams occurring elsewhere, suggesting a need for optimized learning spaces and teaching strategies.
Area of Science:
- Medical Education
- Clinical Pedagogy
Background:
- Bedside teaching (BST) is a cornerstone of clinical education, yet faces challenges impacting its effectiveness.
- Decreased bedside time and evolving teaching methods necessitate a re-evaluation of BST practices.
Purpose of the Study:
- To provide an evidence-based analysis of current bedside teaching (BST) practices.
- To understand the interplay between learning content and the social/spatial dynamics of BST.
- To inform refinements in the didactic design of BST.
Main Methods:
- Empirical analysis of nearly 80 hours of video recordings from 36 BST sessions.
- Utilized high interrater reliability for video content analysis.
Main Results:
- BST sessions averaged 125 minutes, with less than a third of the time spent at the patient's bedside.
- History taking occurred primarily at the bedside; case presentations, clinical reasoning, and theory were taught away from the patient.
- Clinical examinations were conducted equally at the bedside and in theory rooms.
Conclusions:
- Current BST, while typical of undergraduate medical education, is not exclusively conducted at the bedside.
- Optimizing BST requires dedicated learning spaces beyond the bedside and strategic use of small groups and plenary sessions.
- Revising the sequence of clinical examinations before BST and conscious decisions on social structure can enhance teaching effectiveness.
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