Patient selection for bedside teaching: inclusion and exclusion criteria used by teachers. 2012

Benjamin Gierk, and Sigrid Harendza
Department of Internal Medicine, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany.

BACKGROUND Bedside teaching encounters on hospital wards offer medical students opportunities to learn key medical and interpersonal skills. Although many aspects of bedside teaching have been studied, not much is known about the selection process used by medical teachers to find patients for these encounters. Patient selection could have a substantial impact on medical students' clinical experiences. Therefore, we studied the ways in which medical teachers select patients for bedside teaching and tried to determine the factors that affect patient selection. METHODS Using a qualitative research approach, we interviewed 15 teachers from three departments within the Medical Faculty at Hamburg University on how they choose patients for bedside teaching encounters. We extracted selection criteria from the transcripts of the audio-recorded interviews and identified other factors that influenced selection. RESULTS One main category and two minor categories of factors relevant to patient selection were identified: educational; bio-psycho-social, and structural. Medical teachers look primarily for patients who have diseases that fit their conceptions of the learning objectives of the lessons in question. The two minor categories influence their choice of patients in different ways. By finding a balance between these categories, they decide which patients are eligible for participation. As a result of these selection criteria, some patients are more likely to become involved in clinical teaching, whereas others may be omitted. CONCLUSIONS Patient selection for bedside teaching is based on several criteria. Non-representative patient selection may narrow the learning experiences of medical students. Curriculum planners need to be aware that specific aspects of medical care may be neglected as a result of the exclusion of some patients. Teacher training and additional teaching formats should be provided to ensure that these are covered.

UI MeSH Term Description Entries
D007858 Learning Relatively permanent change in behavior that is the result of past experience or practice. The concept includes the acquisition of knowledge. Phenomenography
D008297 Male Males
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D003479 Curriculum A course of study offered by an educational institution. Curricula,Short-Term Courses,Course, Short-Term,Courses, Short-Term,Short Term Courses,Short-Term Course
D004504 Education, Medical, Undergraduate The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D. Medical Education, Undergraduate,Education, Undergraduate Medical,Undergraduate Medical Education
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013337 Students, Medical Individuals enrolled in a school of medicine or a formal educational program in medicine. Medical Student,Medical Students,Student, Medical
D013663 Teaching A formal and organized process of transmitting knowledge to a person or group. Teaching Method,Training Activity,Training Technique,Academic Training,Educational Technics,Educational Techniques,Pedagogy,Teaching Methods,Technics, Educational,Techniques, Educational,Training Activities,Training Technics,Training Techniques,Activities, Training,Activity, Training,Educational Technic,Educational Technique,Method, Teaching,Methods, Teaching,Pedagogies,Technic, Educational,Technic, Training,Technics, Training,Technique, Educational,Technique, Training,Techniques, Training,Training Technic,Training, Academic
D018579 Patient Selection Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. Patient Recruitment,Research Subject Recruitment,Selection Criteria,Research Subject Selection,Selection for Treatment,Selection of Research Volunteers,Selection of Subjects,Criteria, Selection,Recruitment, Patient,Recruitment, Research Subject,Recruitments, Research Subject,Research Subject Recruitments,Research Subject Selections,Research Volunteers Selection,Research Volunteers Selections,Selection for Treatments,Selection, Patient,Selection, Research Subject,Selections, Research Subject,Subject Recruitment, Research,Subject Recruitments, Research,Subject Selection, Research,Subject Selections, Research,Subjects Selection,Subjects Selections,Treatment, Selection for,Treatments, Selection for,Volunteers Selection, Research

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