The clinical teacher
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The clinical teacher · Jun 2013
Comparative StudyCentrally organised bedside teaching led by junior doctors.
Clinical bedside teaching is arguably the most favoured form of teaching by medical students, but has been on the decline in recent years. Junior doctors are often underused as teachers and, with adequate training, may help to solve this problem. Bedside Teachers is a junior doctor-led teaching programme that is delivered throughout South-East Scotland, and is now in its third year. This study aimed to investigate the perceptions of final-year medical students participating in the Bedside Teachers programme, and how they compared this with teaching from senior staff. ⋯ With adequate training, junior doctors can be a useful resource for increasing the bedside teaching opportunities available to students, with potential advantages over using senior staff.
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Professionalism is widely acknowledged as being central to medical practice, and is taught at most UK medical schools. The impact of this teaching in the context of competing influences on a student's developing view of themselves as professional is, however, unclear. We explored the understanding of professionalism in third-year medical students who have recently completed this element of their formal teaching, and related this understanding to previously unexplored wider influences placed upon them during their development. ⋯ The most commonly cited aspects of professionalism by students in this study were confidentiality, good medical knowledge and practical skill. Students also cited promptness, hygiene and appearance as being important, although these factors are rarely cited in the literature. Students cited role models, the media and parents as the three most important influences on their view of professionalism. These merit further consideration in future research and course design. Most students agreed that professionalism should be taught at medical school, but that this would be best achieved within a clinical setting. The favoured model for acquisition of views on professionalism was observation of doctors rather than formal teaching.
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The reduction in the length of hospital stay for surgical patients at a time of expanding medical student numbers has created challenges in the provision of adequate exposure to surgical patients. This has required the use of surgical learning opportunities in the ambulatory setting, including the preoperative assessment clinic. At Keele University, fourth-year medical students follow patient journeys through the preoperative assessment process, gaining experience of history taking, examination, prescribing and practical skills. This is followed by group discussion with a clinical teaching fellow, focusing on management and clinical reasoning. We audited the experience our students gained in the preoperative assessment clinic against the relevant Tomorrow's Doctors outcomes. ⋯ This study shows that students can gain experience in multiple Tomorrow's Doctors outcomes in the preoperative assessment clinic. In particular, it is a useful environment to learn and teach practical procedures, clinical reasoning and decision-making skills.