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床边教学是否已经过时?

Has bedside teaching had its day?

机构信息

Neonatology Department, Edinburgh Royal Infirmary, UK.

出版信息

Adv Health Sci Educ Theory Pract. 2012 May;17(2):301-4. doi: 10.1007/s10459-011-9308-1. Epub 2011 Jun 17.

Abstract

Though a diverse array of teaching methods is now available, bedside teaching is arguably the most favoured. Students like it because it is patient-centred, and it includes a high proportion of relevant skills. It is on the decline, coinciding with declining clinical skills of junior doctors. Several factors might account for this: busier hospitals, broader roles of clinicians, competing teaching modalities, and the limited training of clinicians as medical educators. However, bedside teaching offers unique benefits. Students gain first-hand experience of the doctor patient relationship. They see the process of interacting with patients, investigative yet sensitive, demystified. Certain clinical skills, like the recognition of the tactile sensation of hepatosplenomegaly cannot be simulated elsewhere. We advocate the preservation of bedside learning experience. Teaching guidelines should be written to minimise disruption to ward work, and to ensure the preservation of patient autonomy. Greater emphasis should be placed on bedside skills in the undergraduate curriculum. For teachers, training in teaching methodology should begin at undergraduate level, with subsequent protected teaching time in job plans. This would increase not just the quantity, but also the quality of bedside teaching.

摘要

尽管现在有各种各样的教学方法,但床边教学可以说是最受欢迎的。学生喜欢它,是因为它以患者为中心,并且包含了大量相关技能。它的使用率正在下降,同时初级医生的临床技能也在下降。有几个因素可以解释这一点:医院越来越繁忙、临床医生的角色越来越广泛、教学模式的竞争以及临床医生作为医学教育者的培训有限。然而,床边教学提供了独特的好处。学生可以获得医患关系的第一手经验。他们看到了与患者互动的过程,既有调查性又有敏感性,没有神秘感。某些临床技能,例如对肝脾肿大的触觉感觉的识别,无法在其他地方模拟。我们主张保留床边学习体验。教学指南应编写,以尽量减少对病房工作的干扰,并确保患者自主权得到保留。应该更加重视本科课程中的床边技能。对于教师,教学方法的培训应从本科阶段开始,并在工作计划中提供后续的受保护的教学时间。这不仅会增加床边教学的数量,还会提高其质量。

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