Structure and quality of bedside teaching: A videographic analysis

Abstract

Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.

Keywords:

• Teaching & learning clinical
• teaching & learning methods
• phase of education
• undergraduate
• learning outcomes
• clinical skills

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

AB led data collection, conducted analysis, and authored the manuscript. HR contributed significantly to data collection and analysis. AH aided in methodology development, played a key role in data analysis, and contributed to result discussions. PB supervised the entire project, and MG advised on data-related aspects and contributed to writing.

Additional information

Funding

This work was supported by Else-Kröner-Fresenius Stiftung.

Notes on contributors

Anna-Lena Blaschke

Anna-Lena Blaschke is a paediatric resident in Altötting, Germany. During her medical studies at Ludwig Maximilian University Munich and the Technical University Munich, she joined the translational medicine doctoral program. Researching at the TUM Medical Education Center, she focused on bedside teachings, particularly exploring learning content and the learning environment in clinical settings.

Alexander Hapfelmeier

Alexander Hapfelmeier, a medical statistician at TUM School of Medicine, oversees clinical trials and collaborates on funded projects. Published in clinical, methodological, and health services research, he lectures on medical statistics and supervises doctoral students. His interests encompass clinical trials, health services research, benchmark studies, method comparisons, and predictive modelling.

Hannah P. K. Rubisch

Hannah P. K. Rubisch, a psychiatry resident in Vienna, studied Human Medicine at Ludwig Maximilian University Munich. Her research focuses on bedside teaching, exploring the roles of students, physicians, and patients, as well as the occurrence and learning from errors in the clinical setting. She conducted her research as part of the team at the TUM Medical Education Center.

Pascal O. Berberat

Pascal O. Berberat is a medical educator with dual research focuses. He investigates teaching processes and the behaviours of physicians as educators. Additionally, he explores medical education biographies, emphasizing non-rational aspects in coping with boundary situations. Trained as a surgeon in Bern, Boston and Heidelberg, he is the chair of Medical Education and director of the TUM Center of Medical Education since 2015.

Martin Gartmeier

Martin Gartmeier studied Educational Science in Regensburg, Germany, and finished his Ph.D. on workplace-based learning in 2009. Since his habilitation in 2017, he coordinates the research activities at the TUM Chair for Medical Education. His research interests are professional communication, learning from errors, digital learning and professional learning in different domains.