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   Table of Contents      
LETTER TO THE EDITOR
Year : 2019  |  Volume : 67  |  Issue : 11  |  Page : 1901-1902

Resident-to-resident bedside teaching: An innovative concept


Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication22-Oct-2019

Correspondence Address:
Dr. Atul Kumar
Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_909_19

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How to cite this article:
Kumar A, Agarwal D. Resident-to-resident bedside teaching: An innovative concept. Indian J Ophthalmol 2019;67:1901-2

How to cite this URL:
Kumar A, Agarwal D. Resident-to-resident bedside teaching: An innovative concept. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 18];67:1901-2. Available from: http://www.ijo.in/text.asp?2019/67/11/1901/269642



Residency programmes face a unique challenge to cover a wide breadth of topics in a limited span of time. Due to increased workload and time constraints, faculties or fellows face difficulty to devote enough time for training junior residents.[1] The lectures have a tendency to become monotonous and do not generate active participation from listeners. Sometimes, the residents are also hesitant to ask their doubts. Various authors have devised various strategies to make learning more meaningful.[2],[3]

Bedside teaching has always played an indispensable role in learning medicine.[4] It encourages residents to make use of all their senses as well as learn the humanistic aspect of medicine. Usually, case-based discussions are conducted by experienced faculty or senior residents in a teaching institution.[5] Learning becomes passive and the teacher becomes the primary agent in learning. The learners usually acquire beliefs/experiences of the teacher without questioning it.

We followed a unique approach for training residents at our tertiary eye care centre. It gives teaching power to the residents. This supervised, multilevel resident-to-resident teaching approach helps in the overall development of residents. Residents are given a clinically important topic to read 1-2 weeks before the rounds. All residents are encouraged to study that topic in detail and jot down their queries. In all, 2-3 interested residents agree to discuss that topic in detail, on a voluntary basis. Relevant study material about that topic like book chapters, articles from journals is circulated among the residents via email, WhatsApp or offline mode (printed copies). Pre-rounds, residents learn about the admitted patient and a group discussion is held where assigned residents teach the topic to their fellow residents. All are encouraged to participate actively. It is supervised by a senior resident who moderates the session and answers their queries. Finally, on the day of rounds, the topic is discussed by residents in great detail including bedside comprehensive patient-based management. The final discussion is moderated by senior experienced faculty members. They share their own experiences, bring out the key learning points and correct any query. It is more exhaustive than a case presentation as listener is actively involved in discussion. Every resident is encouraged to contribute actively to the discussion. The presenters prepare a short summary of the discussion covering salient points and circulate among themselves. This approach has got several advantages. It involves active learning where residents are encouraged to think independently, question and critically review things. It creates a sense of a safe environment as the outline of the topic is already discussed before the rounds. It helps in the overall development of residents as they acquire qualities of active listening, prioritization of result oriented goals, organization, flexibility and trustworthiness. It instills a sense of confidence and removes any fear/hesitation. The effectiveness of this innovative teaching methodology is highlighted by the improved academic performance of the residents in ward leaving examination where they scored an average of 72% marks (range: 65%-80%). On previous occasion, they scored an average of 63% marks (range: 55%-75%).

The residents self-evaluated themselves to assess their public speaking skills and confidence using a scale given by Joe et al.[6] The scale scores on nine aspects with a maximum score of 36. The residents reported an initial average score of 17 (range: 12-26) which improved to 25 (range: 20-30) [P = 0.041] after effective implementation of this technique for more than 3 months.

To conclude, this supervised approach will help in spreading meaningful knowledge and building confidence among residents. It is aptly said, “The function of Leadership is to produce more Leaders, not more followers.”

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Salam A, Siraj HH, Mohamad N, Das S, Rabeya Y. Bedside teaching in undergraduate medical education: Issues, strategies, and new models for better preparation of new generation doctors. Iran J Med Sci 2011;36:1-6.  Back to cited text no. 1
    
2.
Ricciotti HA, Dodge LE, Head J, Atkins KM, Hacker MR. A novel resident-as-teacher training program to improve and evaluate obstetrics and gynecology resident teaching skills. Med Teach 2012;34:e52-7.  Back to cited text no. 2
    
3.
Vestal HS, Sidelnik SA, Marcovitz D, Huffman J. A novel resident-as-teacher rotation for second-year psychiatry residents. Acad Psychiatry 2016;40:389-90.  Back to cited text no. 3
    
4.
Hipp DM, Rialon KL, Nevel K, Kothari AN, Jardine LDA. “Back to Bedside”: Residents' and Fellows' perspectives on finding meaning in work. J Grad Med Educ 2017;9:269-73.  Back to cited text no. 4
    
5.
The Art of Leading with the Right Balance as a Senior Resident | NEJM Resident 360 [Internet]. Available from: https://resident360.nejm.org/expert-consult/the-art-of-leading-with-the-right-balance-as-a-senior-resident. [Last accessed on 2019 May 09].  Back to cited text no. 5
    
6.
Joe J, Kitchen C, Chen L, Feng G. A prototype public speaking skills assessment: An evaluation of human-scoring quality. ETS Res Rep Ser 2015;2015:1-21.  Back to cited text no. 6
    




 

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