Johns Hopkins University Master of Education in the
- Slides: 10
Johns Hopkins University Master of Education in the Health Professions Bedside Teaching Anne Belcher, Ph. D, RN, AOCN, ANEF, FAAN MEHP
What is bedside teaching? Ø Direct interaction among the health care provider, the student, and the patient or the patient’s family Ø Purposes include the following: Ø Elicit a history Ø Perform a physical examination or procedure Ø Discuss the diagnosis and best therapeutic approaches Encourages student to problem solve Allows provider to model behaviors such as communication skills, professionalism, and compassion
History of BST • Dates back to the time of Hippocrates, Sylvius and Sir William Osler • Present studies reveal that fewer health care providers teach at the bedside • General agreement throughout academic education that BST is at risk of becoming a lost art
Advantages of BST Ø Helps students transition from classroom to practice setting, where they can become a member of the health care team Ø Provides opportunities for active learning Ø Provides teacher with opportunities for role modeling Ø Allows patients and families to become active participants in their care
Barriers to BST Ø Time—related to pressure to see more patients, fewer patient days, and more documentation Ø However, according to Gonzalo et al (2010), total rounding time (walk rounds and BST together) did not change with the addition of BST Ø Student based barriers include disinterest Ø Teacher based barriers include lack of training, fear of violating HIPAA, lack of dedicated time Ø Patient-based barriers include critical status, discomfort, distress Ø Systems-based barriers include overabundance of technologydriven diagnoses; interruptions
Description of models Ø Microskills of BST (Neher et all, 1992) Ø Ø Ø Get a commitment Probe for supporting evidence Teach general rules Reinforce what was done well Correct mistakes Identify future learning steps Janicik & Fletcher (2003) Domains Domain 1 attends to patient’s comfort Domain 2 focuses on five Microskills Domain 3 addresses group dynamics
Application of adult learning theory to BST • Kolb’s model of experiential learning – Concrete experience – Reflective observation – Abstract conceptualization – Active experimentation
Knowles’ six core principles of andragogy • • • Learner’s need to know Learner’s self-concept Prior experience of the learner Readiness of the learner Orientation to learning Motivation to learn
Student and patient perspectives on BST* • Only 48% of students reported they had been given enough • 100% found it to be the most effective way of learning clinical skills • 77% of patients enjoyed BST • 83% said it did not make them anxious *Nair, BR, Coughlan, JL, & Hensley, MJ (1997). Student and patient perspectives on bedside teaching. Medical Education, 31, 341 -346.
Assessing the quality of BST* • Use of structured, 15 -item objective structured clinical examination checklist • While useful as a tool for assessing quality, the authors noted that BST may be a more inherently subjective process, based on different teaching (and learning) styles *Conigliaro, RL & Stratton, TD (2010). Assessing the quality of clinical teaching: a preliminary study. Medical Education, 44 (4), 379 -386
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