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

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

2. 94% “bedside teaching time is valuable” 82% of residents want MORE Crumlish CM, et al. Quantification of Bedside Teaching by an Academic Hospitalist Group. J Hospital Medicine 2009; 4:304-7.

3. Bedside Teaching Sameer D. Khatri, M.D. Faculty Development Fellow

4. Take home points • Everyone has something to offer • Make a road map • Stay attentive and be flexible

5. Learning objectives • List obstacles to bedside teaching • Identify advantages • Try out models for bedside teaching • Discuss ways to overcome obstacles • Plan integrating into rounds

6. Who learns on rounds? Dale, E. Audiovisual Methods in Teaching, 1969, NY: Dryden

7. So what’s stopping us??? • List obstacles to performing bedside rounds

8. 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

9. Describe the advantages to bedside rounds

10. 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 MAMC FM, 2012 Crumlish CM, et al. 2009

11. How can we do it? • Follow a 12-step model • Follow a 3-domain model • Make up our own model

12. Road maps and focused teaching • Pick one model • Pick a real case • Work through the steps Take 15 minutes

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. Strategies to increaseBedside Teaching See handout

20. Taking it to the Ward What can we commit to now?

21. Learning objectives • Listed obstacles to bedside teaching • Identified advantages • Tried out models for bedside teaching • Found ways to overcome obstacles • Planned integration into rounds

22. Take home points • Everyone has something to offer • Make a road map and follow it • Stay attentive and flexible

23. Questions&Comments