Clinical Teaching: The Bedside and Beyond

Abstract

Medical students learn medicine by caring for patients under the supervision of attending physicians. Most medical care occurs in ambulatory outpatient settings with more acute illnesses and injuries cared for in emergency and inpatient settings. In all settings, the attending physician teaches “at the bedside,” with the patient in a hospital bed or sitting on an examination table. The skills of patient-centered care are role modeled by the attending physician who is simultaneously the healthcare provider for the patient and the teacher or tutor for the student. The clinician must define the expectations, actively involve the student in patient care, and be attentive to both patient and learner. Significant and important principles of patient care, discussion of current medical practices, more sophisticated physical diagnosis and interviewing skills, and learning how to integrate medical evidence with the personal preferences of the patient are learned at the bedside.

Clinical faculty are time pressured to see more patients and to deliver quality care. Teaching techniques will be reviewed with examples from several settings. Discussion of techniques to help the practitioner–teacher be efficient, effective, and incorporate learners in patient care will be reviewed.