Bedside Teaching: Specialists vs. Non- specialists

Word Count: 249 (including titles) Main Text Word count: 1422 (including titles) Number of tables: 2 Deemed exempt from full review by University Research Ethics Committee (UREC) (University of Dundee, UREC Reference number: 11077) This is the peer reviewed version of the following article: ‘Bedside Teaching: Specialists versus Non-specialists’, Clinical Teacher 13:2 (2016), which has been published in final form at http://dx.doi.org/tct.12373 .This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Abstract Background Bedside teaching (BT) is a valuable learning experience for medical students. In 2010, the BT curriculum at the University of Dundee was revised, so that specialised tutors facilitated these sessions. The aim of this study was to compare student opinion of BT delivered by specialist and non-specialist teachers.Background Bedside teaching (BT) is a valuable learning experience for medical students. In 2010, the BT curriculum at the University of Dundee was revised, so that specialised tutors facilitated these sessions. The aim of this study was to compare student opinion of BT delivered by specialist and non-specialist teachers. Methods A retrospective survey was sent to two medical student year groups who received teaching delivered by either specialist or non-specialist teachers during Year 2. Results A 24.5% response rate was achieved, of which 49.4% received specialist teaching. Responses indicated that specialist tutors improved communication skills (p = 0.034), were less intimidating (p = 0.01) and gave greater opportunity to ask questions (p = 0.028) than their non-specialist counterparts. Overall, students taught by specialist teachers rated BT as more valuable (p = <0.001). A positive correlation was noted between the frequency of patient interaction and the overall value of BT (p = <0.0121). However, there was no significant association between the main teaching location and the overall value of BT. Discussion Findings indicate that specialist tutors provide students with a better understanding of disease processes. Several students from the specialist group noted that their tutors linked theory to practice. However, one student noted that specialist tutors discussed cases which were too complicated for their level of study. No significant difference was found between the two groups regarding whether teaching was at an appropriate level. Specialist teachers therefore allow a number of improvements over the use of nonspecialist teachers for BT. Background In the age of patient-centred care, it follows that teaching should occur in the presence of the patient, the definition of bedside teaching1 (BT), in order for learners to acquire skills relevant to their future clinical practice. Indeed, in one study, all respondents felt BT was the most effective way of learning clinical skills but only 48% of learners felt they had enough BT.2 In some medical curricula BT has become a patient-based discussion in a conference room, as faculty are more familiar and comfortable with lecture-style teaching.1-4 It has been found through observation that the median time spent at bedside was 2.5 minutes compared with 69 minutes in the classroom.5 Literature is limited comparing the effectiveness of specialists and non-specialists in the delivery of BT. One study notes that OSCE scores of medical students taught by either specialists or generalists do not significantly differ.6 However, this study also noted that specialists felt less confident in teaching particular skills, such as cardiorespiratory examination, compared to generalists.6 Recent changes from nonspecialist to specialist-led BT at the University of Dundee Medical School provided a useful opportunity to determine if specialist teachers offer any improvements over the use of non-specialist teachers. It was hypothesised that specialist teachers would deliver a more valuable BT programme. The University of Dundee currently delivers “system-based teaching” and so specialists were employed to deliver BT during their specific teaching period. Previously, non-specialists would deliver BT, regardless of the system being taught.