JMIR Publications

ABSTRACT

Background:

Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, it’s usage within medical education has been declining and COVID-19 has added additional challenges. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the utilisation of online learning, social media platforms and simulation. Simulation based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with case standardisation. The results demonstrate simulation-based training can increase student’s confidence, increase the rates of correct clinical diagnoses and improve retention of skills and knowledge when compared with traditional teaching methods.

Objective:

To mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School amidst closure of the cardiorespiratory wards, a high-fidelity simulation based model of traditional bedside teaching was designed and implemented. The objectives of the teaching session were to enable students to perform history taking and a focused cardiorespiratory clinical examination in a COVID safe environment using SimMan 3G.

Methods:

Four clinical teaching fellows with experience of simulation based medical education scripted histories for two common cardiorespiratory cases; asthma and aortic stenosis. The simulation sessions were designed for students to take a focused cardiorespiratory history and clinical examination using SimMan 3G. All cases involved dynamic vital signs and the simulator allowed for auscultation of an ejection systolic murmur and wheezing in accordance with the cases chosen. Key aspects of the pathologies including epidemiology, differential diagnoses, investigations and management were summarised using an interactive powerpoint presentation, followed by a debriefing session.

Results:

In total 12 third year medical students undertook the sessions and overall feedback was highly positive with 91% of students feeling more confident in their clinical examination skills following the teaching. 100% of students responded that they would recommend the session to a colleague and implementation of regular simulation was frequently requested on feedback. These results are in keeping with the current literature.

Conclusions:

Bedside teaching continues to face ongoing challenges from the COVID-19 pandemic as well as declining patient recruitment and fluctuations in clinical findings. The support for simulation based medical education is derived from high quality studies, however studies describing the use of this technology for bedside teaching in the undergraduate curriculum is limited. The authors describe a highly effective teaching session amidst the pandemic which allowed for maintenance of staff and student safety alongside continued education during a challenging time for educators globally. Clinical Trial: Not applicable