4.7 Article

Strategies to Improve Bedside Clinical Skills Teaching

Journal

CHEST
Volume 160, Issue 6, Pages 2187-2195

Publisher

ELSEVIER
DOI: 10.1016/j.chest.2021.06.055

Keywords

KEY WORDS; assessment; bedside teaching; clinical examination; point-of-care technology

Funding

  1. American Medical Association (AMA)

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The bedside encounter between patients and physicians is crucial in medical practice, but modern healthcare systems are seeing less direct contact due to various factors. Strategies such as setting clear goals before bedside encounters, practicing evidence-based approaches, and utilizing point-of-care technology are recommended to improve clinical skills teaching and assessment. Feedback on specific clinical examination skills is also important for learners in various settings.
The bedside encounter between a patient and physician remains the cornerstone of the practice of medicine. However, physicians and trainees spend less time in direct contact with patients and families in the modern health care system. The current pandemic has further threatened time spent with patients. This lack of time has led to a decline in clinical skills and a decrease in the number of faculty members who are confident in teaching at the bedside. We offer several strategies to get physicians and trainees back to the bedside to engage in clinical skills teaching and assessment. We recommend that providers pause before bedside encounters to be present with patients and learners and to develop clear goals for a bedside teaching session. We suggest that clinical teachers practice an evidence-based approach, which includes an hypothesisdriven physical examination. We encourage the use of point-of-care technology to assist in diagnosis and to allow learners to calibrate traditional physical examination skills with real-time visualization of disease. Tools like point-of-care ultrasound can be powerful levers to get learners excited about bedside teaching and to engage patients in their clinical care. We value telemedicine visits as unique opportunities to engage with patients in their home environment and to participate in patient-directed physical examination maneuvers. Finally, we recommend that educators provide feedback to learners on specific clinical examination skills, whether in the clinic, the wards, or during dedicated clinical skills assessments.

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