A systematic review of the current challenges of bedside teaching for medical students in the UK

Bedside teaching (BST) has declined in the UK despite longstanding educational interventions. We sought to outline current barriers and synthesise experiences of medical students and clinical educators to understand organisational dynamics constraining BST.

We conducted a qualitative systematic review following PRISMA 2020, registered in PROSPERO (CRD420251033043). MEDLINE, Embase, CINAHL, and Cochrane Library were searched for 2014 to April 2025. We included UK qualitative or mixed-methods studies on barriers to BST; non-UK studies, reviews, and editorials were excluded. Two reviewers independently screened and appraised studies using the Critical Appraisal Skills Programme (CASP) checklist. Thematic synthesis was performed with line-by-line coding and iterative team discussion.

Four interconnected themes emerged: (1) institutional marginalisation of undergraduate teaching (service pressures, limited recognition/resources), (2) educator constraints and professional isolation (limited training/feedback, competing demands), (3) learner unpreparedness and engagement challenges (insufficient exposure and confidence), and (4) patient-related ethical and practical barriers (reluctance, privacy, infection concerns). These themes formed a self-reinforcing organisational cascade that sustains BST decline.

Barriers to BST in the UK are systemic rather than isolated, reflecting structural misalignment between service demands and educational priorities. Sustainable improvement requires organisational reform and resourcing that explicitly prioritise bedside teaching within clinical practice, alongside continued investment in the educators who deliver it.