Bedside Teaching in Obstetrics and Gynecology

Climate health is gaining prominence in medical curricula worldwide, with academic and healthcare institutions setting targets to reach carbon net zero. However, the integration of evidence-based strategies to reduce carbon footprint in medical education is constrained by a scarcity of research. This research study uses a novel approach to quantifying the carbon footprint of three teaching modalities within an undergraduate medical curriculum. We quantified the carbon footprint generated by delivering bedside, didactic and simulation-based education to undergraduate medical students in a hospital environment. Data were collected on the use of electronic equipment and consumables during each teaching session. Environmentally extended input-output analysis (EEIOA) was conducted to estimate the carbon footprint intensity. A total of 30 teaching sessions were evaluated (bedside = 10, didactic = 10 and simulation = 10). The median carbon footprint intensity for delivering bedside, didactic and simulation teaching was 0.1180 kgCO2e/h/learner, 0.0293 kgCO2e/h/learner and 0.0419 kgCO2e/h/learner, respectively. For context, the average carbon footprint is 0.041 kgCO2e per kilometre for electric vehicles. Bedside teaching had the highest carbon footprint per learner, driven by electronics and personal protective equipment. Didactic had the lowest carbon footprint due to a low or absent requirement for consumables. To the best of our knowledge, this is the first study to propose carbon footprint intensity as a potential outcome measure for evaluating the delivery of medical education. This approach offers a tool to empower educators to quantify the environmental impact of educational activities to support the implementation of low carbon strategies.

In order to improve the teaching effect of obstetrics and gynecology a questionnaire survey among medical students was carried out in the Affiliated Zhongshan Hospital of Dalian University to know the views and the suggestions of bilingual teaching in obstetrics and gynecology. Through analysis, it showed that the effect of bilingual teaching was influenced by student's English level, the teachers' quality, teaching materials and the teaching arrangement. Key words: Bilingual teaching; Obstetrics and gynecology; Questionnaire

This article was migrated. The article was marked as recommended. Background: Bedside teaching used to be an integral component of undergraduate medical education. In recent times, however, there has been a steady decline in the use of bedside teaching. This has occurred despite students, clinicians and patients viewing bedside teaching as valuable. Aims: This review aims to appraise the current literature surrounding the perspectives in bedside teaching and evaluate its role within modern medical education. Methods: A literature search was conducted in PubMed, Cochrane Library, and Ovid to identify appropriate studies. The journal articles were obtained by conducting sensitive and appropriate searches using keywords. All studies were examined comprehensively by the authors for suitability for inclusion. Results: 2,770 records were identified from the initial search. An additional 3 records were identified after discussion with experts in the field. 583 duplicates were identified in the pool of records initially sourced. Of the remaining 2,190 records, 1,930 were excluded after inclusion and exclusion criteria were applied to their titles and abstracts. A further 252 records were excluded from the remaining 260 records after inclusion and exclusion criteria were applied to their full-texts. The remaining eight articles were reviewed by both authors and were deemed suitable for inclusion to the review. Conclusion: The review showed that there is evidence in the literature to show that students, clinicians, and patients regard bedside teaching as beneficial. Discussions highlighted that bedside teaching can aid competency-based education models and cannot be replaced by simulation-based education. These results illustrate that, while there is evidence to show that bedside teaching holds value in medical education today, further studies should be conducted aiming to display long-term outcomes of bedside teaching.

PurposeThe COVID-19 pandemic has imposed severe challenges on medical education at German university hospitals. In this first German nationwide expert survey, we addressed the responsible university teaching coordinators in obstetrics and gynecology departments and investigated their experiences during the pandemic as well as their opinions on future developments, especially with regard to the broader implementation of e-learning in the standard curriculum.MethodsThe questionnaire included 42 items and was disseminated among teaching coordinators at all 41 departments of obstetrics and gynecology at German university hospitals via an email that included a weblink to the online survey provider. Responses were collected between 19 April and 7 June 2021.ResultsIn total, 30 responses were collected from 41 departments across Germany and their respective teaching coordinators in obstetrics and gynecology. The general opinion of the medical teaching provided during the pandemic was positive, whereas the teaching quality in practical skills was considered inferior and not equivalent to the standard face-to-face curriculum. Lectures and seminars had to be substituted by remote-learning alternatives, while clinical clerkships were reduced in length and provided less patient contact. Students in their final year experienced only a few differences in the clinical and teaching routine. Teaching coordinators in obstetrics and gynecology stated that they intend to incorporate more e-learning into the curriculum in the future.ConclusionThe medical educators’ views presented here may help to complement the already-thoroughly investigated experiences of students under the restrictions of the COVID-19 pandemic. Medical educators in obstetrics and gynecology at German university hospitals have successfully established online and hybrid teaching alternatives to their standard face-to-face courses. Building on recent experiences, digitalization could help to improve future medical education.

Many barriers have been cited in reference to why bedside teaching rounds have decreased in frequency during graduate medical education. One perceived barrier to the use of bedside teaching rounds is a fear of it causing patient discomfort or dissatisfaction. The objective of this study was to compare patient perception of bedside versus nonbedside teaching rounds. Study participants were adults admitted to a family medicine inpatient team at a large university teaching hospital. Upon admission, participants were randomized to receive bedside or nonbedside teaching rounds conducted by a team consisting of medical students, family medicine residents, and one attending physician. Each participant completed a questionnaire administered on the day of discharge assessing patients' perception of their involvement in medical decision making, trust in the medical team, satisfaction with care, and provider compassion. Statistical analysis was performed to examine any differences between the two groups. The vast majority of the sample indicated that they knew what they were being treated for in the hospital (n = 105, 98%), reported the medical team spent an adequate amount of time with them (n = 100, 94%), and reported the medical team explained the diagnosis and care in easy-to-understand terms (n = 101, 94%). On 1- to 5-point scales, participants reported that the medical team involved them in making decisions (4.62, standard deviation [SD] 0.72), they trusted the medical team (4.91, SD 0.32), they were satisfied with their care (4.85, SD 0.38), and their medical team was compassionate toward them (4.84, SD 0.44). Overall levels of satisfaction were positive on all of the measures, with no statistical significance between the two groups regarding measures of involvement in medical decision making, trust in the medical team, and satisfaction with care. Interestingly, subjects perceived level of compassion of their medical team to be significantly higher with a bedside teaching approach compared with a nonbedside approach. Despite concerns that bedside teaching rounds may lead to patient discomfort, this study found no evidence supporting this perception. In fact, patients may perceive a medical team that engages in bedside teaching rounds as being more compassionate providers, supporting a patient-centered argument that teaching rounds should return to the bedside.

Introduction: Medical students have long provided informal, structured academic support for their peers in parallel with the institution’s formal curriculum, demonstrating a high degree of motivation and engagement for peer teaching. This qualitative descriptive study aimed to examine the perspectives of participants in a pilot peer teaching programme on the effectiveness and feasibility of adapting existing student-initiated peer bedside teaching into formal bedside teaching. Methods: Study participants were senior medical students who were already providing self-initiated peer-led bedside clinical teaching, clinicians who co-taught bedside clinical skills teaching sessions with the peer teachers and junior students allocated to the bedside teaching sessions led by peer teachers. Qualitative data were gathered via evaluation form, peer teacher and clinician interviews, as well as the observational field notes made by the research assistant who attended the teaching sessions as an independent observer. Additionally, a single Likert-scale question on the evaluation form was used to rate teaching effectiveness. Results: All three peer teachers, three clinicians and 12 students completed the interviews and/or questionnaires. The main themes identified were teaching effectiveness, teaching competency and feasibility. Teaching effectiveness related to the creation of a positive learning environment and a tailored approach. Teaching competency reflected confidence or doubts about peer-teaching, and feasibility subthemes comprised barriers and facilitators. Conclusion: Students perceived peer teaching effectiveness to be comparable to clinicians’ teaching. Clinical peer teaching in the formal curriculum may be most feasible in a hybrid curriculum that includes both peer teaching and clinician-led teaching with structured training and coordinated timetabling. Keywords: Peer Teaching, Undergraduate Medical Education, Bedside Teaching, Medical Students

Asynchronous e-learning allows for targeted teaching, particularly advantageous when bedside and didactic education is insufficient. An asynchronous e-learning curriculum has not been studied across multiple centers in the context of a clinical rotation. We hypothesize that an asynchronous e-learning curriculum during the pediatric emergency medicine (EM) rotation improves medical knowledge among residents and students across multiple participating centers. Trainees on pediatric EM rotations at four large pediatric centers from 2012 to 2013 were randomized in a Solomon four-group design. The experimental arms received an asynchronous e-learning curriculum consisting of nine Web-based, interactive, peer-reviewed Flash/HTML5 modules. Postrotation testing and in-training examination (ITE) scores quantified improvements in knowledge. A 2 × 2 analysis of covariance (ANCOVA) tested interaction and main effects, and Pearson's correlation tested associations between module usage, scores, and ITE scores. A total of 256 of 458 participants completed all study elements; 104 had access to asynchronous e-learning modules, and 152 were controls who used the current education standards. No pretest sensitization was found (p = 0.75). Use of asynchronous e-learning modules was associated with an improvement in posttest scores (p < 0.001), from a mean score of 18.45 (95% confidence interval [CI] = 17.92 to 18.98) to 21.30 (95% CI = 20.69 to 21.91), a large effect (partial η(2) = 0.19). Posttest scores correlated with ITE scores (r(2) = 0.14, p < 0.001) among pediatric residents. Asynchronous e-learning is an effective educational tool to improve knowledge in a clinical rotation. Web-based asynchronous e-learning is a promising modality to standardize education among multiple institutions with common curricula, particularly in clinical rotations where scheduling difficulties, seasonality, and variable experiences limit in-hospital learning.

Upon reading “Teaching During the Pandemic,”1 by Redinger and colleagues, which outlined embracing informal teaching in the clinical environment, I wanted to highlight the role of bedside teaching during the COVID-19 pandemic. Bedside teaching has been a cornerstone of medical education since the time of Sir William Osler in the 19th century.2 Bedside teaching remains an important teaching modality for educators to teach physical examination skills and to role model professionalism, effective communication, and compassionate patient care.3 Despite studies demonstrating these benefits of bedside teaching, the practice of this modality is in decline.4 One study found that teaching at the bedside comprises only 17% of instructional time by academic hospitalists.5One might assume that the COVID-19 pandemic would further lessen time at the bedside, as hospitals limit trainee exposure to patients under investigation for COVID-19 and enact personal protective equipment conservation measures. But it has not. From my observations, bedside teaching is making an interesting resurgence.As a medical education research fellow in a university-based emergency department, I have noticed that the true art of bedside teaching—particularly in communication and professionalism domains—has once again become a focus, bringing patients and health care teams together. Prior to this pandemic, emergency medicine trainees typically assessed and treated patients with direct supervision by faculty members, but often without direct observation of each patient encounter.With COVID-19, it is now the norm for faculty members to gather teams of trainees, nurses, and other key providers around a videoconference call with the patient, intently listening to the patient history, discussing treatment plans as a team, and communicating complex or upsetting information. Team-based, video-enhanced “bedside” teaching provides trainees additional opportunities for observation of history taking. The format allows faculty members to model professionalism and expertise in counseling patients during times of uncertainty. It allows health care providers to function as interprofessional teams, rather than siloed providers working in proximity to one another.The best aspects of bedside teaching are back, even if the COVID-19 pandemic keeps us physically distanced from the bedside.

Introduction: Hybrid teaching method has been implemented in majority of medical schools to adapt with the Covid pandemic era. With this integrated method, we aim to determine the student’s experience, satisfaction and barriers of hybrid undergraduate teaching in obstetrics &amp; gynaecology posting. Methods: A cross sectional study was conducted among medical students undergoing hybrid teaching during obstetrics &amp; gynaecology posting in the year of 2020 and 2021. Participants were 112 fourth and fifth year medical students whom were affected by the pandemic. Online questionnaires through Google forms were distributed to all eligible students. The questionnaire consists of four sections: socio-demographic, experience, satisfaction and barriers. Results: The response rate was 75%. Majority (90.2%) of the respondents were satisfied with the hybrid teaching. Among the barriers that sometimes encountered by our students were inability to adjust learning style, lack of technical skills, mental health difficulties, emotional difficulties, unreliable internet access and an unconducive study environment. Among all the demographic data studied, only ethnicity showed a significant association with the satisfaction of the students. Conclusion: Our study found that majority of students were satisfied with hybrid teaching with minimal barriers experienced. Hence its practice can be continued as it can be utilised at any time as compared to traditional teaching.

Étude d’évaluation de la satisfaction des étudiants en médecine de la faculté Denis-Diderot-Paris-VII concernant leur formation en gynécologie obstétrique

Virtual reality technology, or VR technology, has been rapidly popularized and developed in various fields since 2016 due to its powerful immersion, interactivity, and conceptualization. Even modern medicine combined with VR for disease diagnosis and treatment is no longer a fantasy, and the launch of virtual classrooms has opened a new door for medical education. For the clinical surgery teaching of gynecology and obstetrics, the teaching expectation is very high. Clinical surgery teaching hopes to achieve the best teaching results in the shortest time, and rapid growth requires a lot of training and accumulation. In actual clinical teaching work, there is a gap between reality and ideals. Regular trainees do not have many practical opportunities. But VR technology is likely to solve this problem, and can even be extended to the surgical teaching for interns in obstetrics and gynecology rotation, general practitioners, etc. In addition, the application of robot-assisted surgery technology in obstetrical and gynecological surgeries is becoming more and more mature, which brings new possibilities for VR technology-assisted clinical surgery teaching.

Application of self-directed teaching methods related to microlecture and flipped classroom in the teaching of obstetrics and gynecology in a non-directly affiliated hospital

Obstetrics and gynecology

Objectives:The aim of this study was to find out how stories and anecdotes might improve the quality of the daily morning obstetrics and gynecology (O and G) teaching and determine if the emotions generated by the stories and anecdote deepened the understanding of medical topics.Materials and Methods:The overarching approach to this study was action research. On two occasions, I told stories using PowerPoint presentation during the morning teaching in the O and G seminar room to 10 and 11 learners instead of the traditional factual presentation of a medical topic. The learners ranged from the 3rd-year medical students to 4th-year specialist trainees in O and G and a consultant anesthetist. Each learner completed a feedback questionnaire at the end of the teaching session. I noted the learners' comments and analyzed written feedback.Results:More than 90% of the learners agreed or strongly agreed that the stories were appropriate for their level of training, and on both occasions, every single learner agreed or strongly agreed that the stories improved the quality of the morning teaching. On both days all but one learner agreed or strongly agreed that the stories improved their understanding of the medical topics, and a senior O and G trainee wrote that the story was: “useful – improved my understanding of situation involved.” The stories generated a lot of emotion in the learners, emotions that deepened their understanding of the topic covered.Conclusion:Stories and anecdotes appear to improve the quality of teaching, and this was the case regardless of level of training and experience of the learner. Hence, stories and anecdotes may be an excellent teaching tool in a setting like the morning teaching where the learners are quite varied.

The Teaching of Obstetrics and Gynecology from the Point of View of a General Practitioner