Thursday, May 29, 2014

Bedside Teaching


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From my History of Medicine perspective, bedside teaching came to medical education as a major advance in teaching technique. It's what I experienced in medical school some 50 years ago and it was priceless.
In one form or another teaching at the bedside probably existed clear back to the Asclepian schools of medicine. Certainly preceptor-training took place at the bedside, but the breakthrough came with the university system of medical education wherein highly distinguished professors examined patients and taught small groups of students at the bedside.
Formal bedside teaching as we came to know it, grew to a fine art in Edinburgh with Hodgkin, Addison and Bright and later among the Irish professors: Cheyne, Corrigan, Stokes, Adams and Graves in Dublin around 1818.
Today, teaching rounds tends to be in the hall or in a conference room far removed from the patient. Confidentiality inhibits discussion in a two bed room and professors themselves no longer have the skill in dealing directly with the patient or teaching in front of the patient.
It behooves the student to force the issue, however. Get the patient's permission and then drag the professor reluctantly to the bedside. Introduce your instructor; show him or her the pathology. Tell the story and insist on comment and opinion. It should be easy to chide the professor or teaching fellow away from the conference room and once in the hall say, let's look in on this case; my patient is expecting you.
Once learned this habit of bedside teaching will serve the physician in dealing with consultants and or referring physicians -- providing a continuity of information and care at the patient's bedside.

 

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