Kroenke K, Omori D M, Landry F J, Lucey C R
Department of Medicine, Uniformed Service University of the Health Sciences, Bethesda, Md, USA.
South Med J. 1997 Nov;90(11):1069-74. doi: 10.1097/00007611-199711000-00002.
Clinical teachers have been exhorted to "return to the bedside" so that the three critical parties-teacher, trainee, and patient-can participate together in the educational encounter. The presence of the patient is deemed essential for the optimal demonstration and observation of physical examination, medical interviewing, and interpersonal skills, as well as role-modeling professional and humanistic behavior.
This essay reviews the challenges inherent in bedside teaching and proposes strategies to enhance both the effectiveness and efficiency of such teaching.
Practical suggestions are provided regarding teaching issues (time constraints, group accommodation, selectivity, demonstration, observation, case presentations), learning climate for both teacher and learners, hospital and patient barriers, and selected other issues.
Despite changes in the clinical setting and financing of medical education, patient-centered teaching will remain essential to the training of future clinicians. Techniques described in this paper can be useful in facilitating such bedside teaching.
临床教师一直被敦促“回归床边”，以便教师、实习生和患者这三个关键群体能够共同参与教学过程。患者的在场被认为对于体格检查、医学问诊和人际沟通技巧的最佳示范与观察，以及职业和人文行为的榜样塑造至关重要。
本文回顾了床边教学中固有的挑战，并提出提高此类教学有效性和效率的策略。
针对教学问题（时间限制、群体容纳、选择性、示范、观察、病例汇报）、教师和学习者的学习氛围、医院和患者障碍以及其他一些选定问题提供了实用建议。
尽管临床环境和医学教育资金有所变化，但以患者为中心的教学对于未来临床医生的培训仍将至关重要。本文所述技术有助于促进此类床边教学。
