Bedside Teaching – Insights Into the Medical Student Experience and Likely Impact on Future Role as Clinical Teacher

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Evidence suggests that clinical teaching has declined in recent years for a variety of reasons (Alpert, 2009), while clear benefits exist when it is done well, particularly concerning history-taking and communication skills. Qureshi (2014) suggests that development of teaching skills should be incorporated into the undergraduate medical curriculum, while Charnell et al (2018) advocate providing training after graduation and as an integrated part of an induction programme. No such strategies currently exist for our graduates, and there is a lack of opinion regarding their expectations and ability to deliver bedside teaching. Methods This qualitative study sought to explore the varied experiences of doctors with regards to bedside teaching, and the influence such encounters may have on their future potential role as educator. In-depth interviews were conducted with fourteen final year medical students to gain a detailed understanding. An interpretative phenomenological approach was used for data analysis to organise the data into themes and sub-themes. Results Medical students identified a range of affirmative and challenging aspects regarding their undergraduate experiences. All recognized important practices necessary to meet individual learning needs and highlighted the positive impact such experiences would have on their future role as educators. Students preferred receiving constructive feedback as opposed to positive or no feedback at all, and all acknowledged a sense of responsibility towards being a future educator. Conclusion The findings of this study suggest that while medical students recognise the role of doctors as clinical educators and strive to fulfil this responsibility based on their own undergraduate experiences, training in the art of clinical teaching would be of benefit to all. Medical students undergraduate education clinical teacher bedside teaching. Figures Figure 1 INTRODUCTION The benefits of bedside teaching have long been established especially in relation to honing communication skills, clinical skills, history taking and professionalism (Qureshi, 2014). Medical students and doctors are rarely taught how to conduct bedside teaching sessions but are expected to perform the role of clinical teacher once qualified, and frequently discover teaching to be essential to their career development and progression (Cheesman, 2009). Formal education courses exist and are often expensive and seen as time consuming, making them less attractive for busy doctors with significant clinical commitments. Janicik et al (2008) recommends that clinical educators conduct structured sessions with set teaching goals and time limits, but without proper instruction, clinical teaching sessions can often be of variable quality, unpredictable, pitched at the wrong level and involve approaches such as humiliation or intimidation (George et al, 2006). Many doctors therefore, have no formal instruction on how to carry out teaching sessions at the bedside, and are often unaware of strategies to engage learners, while others may be unfamiliar with the clinical curriculum and assessment methods. Furthermore, current evidence suggests that clinical teaching has declined in recent years for a variety of reasons, and novel options such as simulation now provide more controlled patient encounters (Alpert, 2009). The Irish Medical Council (2019) recognises the importance of clinical teaching for future safe patient care, and encourages all doctors to participate as an important component of medical professionalism. In an effort to create a future generation of effective clinical teachers, Qureshi (2014) suggests that development of teaching skills should be incorporated into the undergraduate medical curriculum, while Charnell et al (2018) advocate providing training after graduation and as an integrated part of an induction programme. No such strategies currently exist for our graduates, and there is a general lack of opinion from graduates and students regarding their expectations of and ability to deliver bedside teaching in the clinical environment. Being physicians and clinical educators ourselves, it is our understanding that the roles of ‘clinician’ and ‘teacher’ to the next generation of doctors in our work are intrinsically linked. However, it can be difficult to fulfil both roles adequately in the context of a challenging hospital environment with many competing interests both in and out of work. From our interactions with other colleagues, we are aware that not every doctor shares the same desire or capacity to teach. We are also cognisant of the additional pressures and challenges faced by female medical students in a traditionally male-dominated field that can impact their learning experiences and desire to be involved in clinical teaching at a later stage. Thus, the purpose of this research was to explore the knowledge, attitudes and planned behaviours of medical students regarding bedside teaching sessions, and whether these experiences have an impact on their future role as clinical educators. METHODOLOGY A qualitative social constructivist approach (Green & Thorogood, p. 13, 2004) was used to gain direct and unbiased opinions from the study participants, which could be analysed later for emerging patterns or thoughts. It also yielded a narrative report and facilitated the use of participant quotations in the final write-up (Hancock, 2009). In-depth semi-structured one-on-one interviews were carried out using an interview guide with open-ended questioning ( Appendix 1 ). The decision to conduct interviews was considered appropriate for this study as the depth of meaning in relation to bedside teaching was important, and this project was primarily focused on gaining insight and understanding (Newton, 2010). All University of Galway final year Medical students based at Mayo University Hospital during the study period (March and April 2020) were initially invited via email to take part in the study. A snowball sampling approach was used where initial participants were asked to endorse interest to their peers who could also add to the study. This was necessary to gain sufficient numbers due to the students’ varying schedules whilst on clinical rotations. An information sheet indicating the purpose of the research was provided and confidentiality was guaranteed. Confidential interviews were audio-recorded to facilitate subsequent transcription and analysis of results. An interpretative phenomenological approach and inductive analysis were used to organise the data from participants’ individual responses into emergent themes and sub-themes about their experiences and perspectives (Smith et al, 1999). Ethical approval was sought from University of Galway College of Medicine, Nursing and Health Sciences Research Ethics Committee. Following recruitment, informed consent was obtained from each of the fourteen participants prior to conducting interviews. RESULTS Fourteen final year undergraduate medical students (8 male, 6 female) were interviewed with none of the participants withdrawing consent during or after the research process. Three main themes were identified from the data which were intertwined with the proposed aims of the study (Figure 1). The themes and associated subthemes are outlined below (Tables 1-3). Table 1: Subthemes and descriptive examples of Theme 1 – Personal motivation for being a future clinical teacher THEME SUBTHEMES DEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES Personal motivation for being a future clinical teacher A sense of responsibility and reward Many participants mentioned a sense of responsibility to teach students similar to the way that doctors taught them when they were students, in addition to the personal rewards: “It's very much where the people who have gone ahead of you, who are experienced in the profession, that they would then teach the younger people coming through and teach different tips and tricks like any other trade” (P2) “It's personally rewarding when you feel like you're educating the next group and then another part would be whenever you teach something, you reinforce it in your own learning and you get to know something better by them asking you questions. It makes you think of things in different ways, it's also good for your own development and learning of a topic” (P2) “ I think it's important to give back because there's all these people throughout my medical education that gave their time freely to me, so I think it's important to give back to the younger generations and help them” (P6) Positively contributing to student learning & experience Participants revealed a desire to contribute to the education of the younger medical students in an effort to help prepare them for the many challenges ahead of them in Medicine: “ I've never always been the smartest or the genius in the room or in the group, or in a bed side, and I felt sometimes left behind, whereas I've had experiences with teachers, to them it didn't matter that one person shone, but that everybody got it, and everybody came up to that standard where they could be safe doctors.” (P1) “I want to become the kind of tutor that makes students feel comfortable, and makes the learning environment safe and not stressful, because I have often found bedside tutorials to be sort of daunting... You don't know what you're going into and don't know what you will be get asked... So I want to be the tutor that makes students feel like they can actually learn anything” (P14) Promotion of a culture of support for students From their personal experiences as medical students, participants appreciated those teachers who were supportive of them regardless of their rank in the class and were determined to act in a similar role for their future students: “I'd really like to be a part of our culture of courage, culture that motivates, that promotes healthy learning, that promotes learning and growing, not just knowing everything today, but continually growing, continually improving, and I really like to just journey with students who may not be the stars, but just to be there for them and teach them...” (P1) Table 2: Subthemes and descriptive examples of Theme 2 – Influence of undergraduate experiences on role as future clinical teacher THEME SUBTHEMES DEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES Influence of undergraduate experiences on role as future clinical teacher Effective learning Learners learn more successfully when new knowledge and skills are applicable to real life situations, and when they are provided with opportunities to enhance their practical skills and develop critical thinking through active learning (Karge et al, 2011). This was echoed by the participants in this study: “If the patient had a murmur she would get every single one of us to listen to it and make sure that we heard it..... The kind of stuff that you hear about, you read about in books, but you might not necessarily understand, and she made sure that every person in the group understood what it was before she moved on to the next thing, which I found very good” (P3) “I remember doing an abdominal exam, she would be literally there with you, making sure that you palpated it correctly” (P7) “I just felt that it was kind of my first time seeing a patient like that on the wards, and I just felt it was very good. There was a lot of signs to look out for and how you could approach it and just be more comprehensive……I went in knowing very little but came out having a very good knowledge…” (P8) Unhelpful occurrences at clinical teaching sessions One participant described the experience of being subjected to inappropriate and poor clinical teacher behaviour: “All of us just felt so embarrassed because he made comments such as “how on earth do you not know this... this is first year anatomy, this is absolutely ridiculous. Who is your tutor?” And then you start to feel really, really... just terrible about yourself. I don't think that I learned even though he did teach and he did know the information himself, but you just felt talked down to…………..sometimes people have a lot of knowledge in their head but not all doctors can teach” (P1) “I think I remember one bedside tutorial where it was with a consultant and the patient was there, and he was very harsh on the students and it got to the point where the patient got very awkward because he started to feel bad for the students. There was just not a nice vibe surrounding it as a whole because even the patient realized it was not very nice and his co-operation started to get less” (P10) “It was a group of about 6 or 7 of us and we didn't get much hands-on experience. He would also throw random questions at people, so everyone was on edge. And if they got the question wrong, they were embarrassed. You end up focusing more on not messing up, as opposed to learning, so as not to embarrass yourself...” (P12) Clinical teachers as Role Models Role models inspire and motivate those working with them to grow and develop in order to achieve their full potential (Azer, 2005). Many participants identified such attributes in their clinical teachers: “Your tutors who are also doctors, they show different ways of communicating to the real patient, different ways of reaching the patient, of asking them to do certain things” (P1) “…a lot of the people as students, you'd look up to are the people that take the time to spend with you and to teach you, especially the consultants” (P6) “So I think a good clinical educator will definitely affect how a student perceives him/herself as a doctor” (P11) “Having really good educators, doctors or tutors. You would leave a tutorial thinking 'God, I'd like to be like them. I'd like to have that likability, confidence and knowledge'. And not even just knowledge, but the ability to impart that knowledge to others. It's very impressive. When you leave a tutorial like that, it is quite inspiring. The great tutorials stand out to this day” (P12) Table 3: Subthemes and descriptive examples of Theme 3 – Student expectations of bedside teaching sessions THEME SUBTHEMES DEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES Student expectations of bedside teaching sessions Feedback The provision of feedback to students has been shown to have a positive impact on clinical performance (McKenzie et al, 2017), and this notion resonated deeply with the participants: “…the only thing worse than bad feedback is no feedback….” (P5) “I didn't learn anything. I just, you know, was winging it, getting by, but in an exam you need someone to be like ꞌno that's why you do thisꞌ...” (P7) ‘The reason it was a good bedside tutorial experience was because when he came back into the room, we went over the history, the exam, the management plan, and then we went through what we were missing at the bedside with the patient, what could have been more important to ask, and what signs or symptoms we didn't see or recognize. So it kind of consolidated the learning all together, and we realized the mistakes we made, and he helped us to improve it, so that the next time we see a patient like that, we have a better approach to it and better understanding.’ (P9) “The feedback is usually the most important part. Just bringing you to a patient, doing an exam and not getting any feedback is not particularly helpful…….. I think it's important not to sugar-coat things too much either- to tell you what you did well, what you didn't do well, and what you need to improve on, and not anything personal or extreme like ' you're really poor' or 'this is not acceptable'. Instead, just saying things like 'You need to improve this for when you're working'. I think that's the most important type of feedback” (P10) Teacher attitude/ behaviour Good clinical teachers are excellent communicators, enthusiastic for teaching and are respectful towards the students (Goldie et al, 2015). This resonated with many of the participants: “…they have an encouraging attitude, they're willing for everybody to learn” (P1) “Someone that can communicate well with patients. If a patient trusts the educator and knows what the main goal of this is, and why they're helping, and can explain clearly to the patient the benefit of this, the patient interacts well with the students too, and I suppose being kind, and someone you can trust as well so that there is confidentiality there” (P4) “She was a really encouraging. She'd say, ꞌGood what could that be a sign of? ꞌ So it wasn't just kind of encouraging, it wasn't a dead pan stare, and she was saying….ꞌOkay, good. Now we will move on to thisꞌ (P5) “Patience, because the student will get things wrong or may be slow or not know certain answers. You can't expect them to be perfect” (P12) “I think they should be just nice if someone messes up or doesn't know, and just kinda move on and not embarrass the student or focus on them. Or if they can tell that someone is shy and they don't want to answer, then maybe stay away from them” (P14) Structured sessions Learners preferred organized teaching sessions with a clear purpose, defined teaching points and relevant learning outcomes: “…..a tutor needs to take enough preparation to be like ꞌthis is the topic we're doing, this is what I want to ask, these are the things you should be looking forꞌ……….and has examined the patient in advance, that they haven't just gone to the Nurses station saying “can I have a Resp patient” because then they're as lost as the people that don't know the diagnosis. And they don't know where they’re going” (P5) “One tutor, she had like five or six names every time, so if one was gone she knew another one, she knew the story with all of them so we were never left high and dry, whereas another tutor, never had any one prepared, and would be like ꞌstudents find people for the student thingꞌ and then that one patient would be gone or something, and then it would be like a car crash” (P7) “I think it's important to go in knowing what you want the students to learn, some learning outcomes, all that kind of stuff, and generally, the poorer ones I've have tended to kind of struggle to get... to communicate what they want the students to know.’’ (P6) Group size All participants preferred smaller groups of students as larger groups were repeatedly viewed as a major barrier to learning. “Sometimes performance anxiety kicks in in bigger groups……..sometimes the patient themselves get performance anxiety, they don't give a good history if they're nervous or self-conscious” (P4) “There were too many students, I think that limited the scope of improving your knowledge and asking questions with the patient. We couldn't really conduct it appropriately, so it wasn't really beneficial for us” (P9) “So if there could be a way to keep it in smaller groups so everyone gets a chance” (P13) “If you have a small size like three or four, and you can really go in depth then and get to know what each person's strength and weaknesses are, whether they're with communication, whether it's confident, whether it's knowledge, when it's practical skills, 'cause all those can be tested and evaluated in a bedside teacher” (P1) ‘‘I think smaller numbers works better, and that's why sometimes if we went in twos or threes I felt it was just a better learning experience because you were asked more questions, you got to do more of the exam and obviously that's kind of more beneficial in terms of the examinations’’ (P8) DISCUSSION The results of this study highlight a varied range of experiences with bedside teaching, but depict a generally favourable view by medical students towards clinical bedside teaching and the desire to become clinical educators in the future. Key insights from this study are as follows: Personal motivation for being a future clinical teacher Our research illustrates how medical students recognise a variety of personal benefits to combining the future roles of both doctor and teacher. Previously echoed in the literature (Dahlstrom et al, 2005; Steinert & MacDonald, 2015), our participants reported a sense of fulfilment and altruism as key motivators to helping learners learn. These factors coupled with a reported obligation to teach junior colleagues, convey an element of gratitude for the positive undergraduate learning experiences they themselves encountered, and many identified teaching as a form of recompense for their own training. Other contributors highlighted their intention to cultivate an inclusive and supportive learning environment in order to inspire and motivate all future learners, clearly recognising the importance of creating a psychologically safe atmosphere to maximise enjoyment in learning (Greenberg, 2016). Not surprisingly, Von Below et al (2018) indicate that Junior doctors are appropriate and effective clinical teachers, as they are often viewed as amenable and empathic, and have a tendency to best understand the learning needs of medical students, having recently been in that position themselves. Influence of undergraduate experiences on role as future clinical teacher This study clarifies how experiences as an undergraduate can inspire medical student confidence and motivation to be a future clinical teacher, particularly if clinical interactions were constructive and supportive. It is important to note that not all doctors are capable teachers even when armed with excellent medical knowledge, as some engage in inappropriate behaviours and teach by humiliation. Colenbrander (2020) reminds us that such practices still persist and many participants in this study reported witnessing or being subjected to intimidating teaching styles. Such encounters inevitably served as a valuable lesson for our participants on how not to teach, ensuring a determination to do better when they themselves are in the role of clinical teacher. Learning is an active process and for an effective teaching session to progress, the learning needs of the students must always be taken into account (Karge et al, 2011). Many participants recalled accounts of enjoyable learning experiences, where they were able to hone their history-taking and clinical skills under Lecturer supervision, and enhance their critical thinking through reflection on the case encountered. During such learning events, knowledge was consolidated and learners were able to appreciate skills applicable to the real life clinical setting, and their future role as doctors. Many participants cited being impressed by excellent teachers, whom they considered as role models. Wright (1997) informs us that clinical skills, personality and teaching ability are the most notable attributes of clinical teachers who are considered as role models by medical students. In addition, providing a positive learning environment, having a steady awareness of the curriculum and an ability to incorporate the learning needs of the students, feature readily as essential characteristics for role models in medical education (Burgess, 2016). Several participants were aware of the enjoyment and contentment experienced by doctors in their role as teacher, and were conscious of the ease of learning from such individuals. This led to many participants being inspired to consider their own potential contribution to medical education in the future, in order to facilitate the development of future competent doctors delivering safe patient care. Student expectations of bedside teaching sessions In addition to the various attributes of effective teachers, the ability to provide feedback is consistently favoured by medical students in order to exact improvement in their performance (Gray et al, 2017). Such sentiments were reiterated by our participants who preferred constructive feedback-in-action that was readily provided at each clinical teaching session. Some participants placed a greater value on teachers who made corrections with a focus not just on formal assessments, but on the learners working effectively and competently as future doctors. In addition to helpful comments, participants appreciated being treated with respect by kind, patient, compassionate teachers, who excelled in providing encouragement to allow learners to grow into their future professional roles. Participants had very clear expectations of their teachers, preferring structured organised sessions with clear learning objectives, yet it is interesting that they cited time pressures as one of the main barriers to their own teaching intentions once working as doctors. In an effort to address this, teaching hospitals will need to invest in practical solutions such as protected teaching times for practicing doctors involved in education. Group size also featured as a concern for many participants. Cooper et al (1983) reported a trend for better performance in physical exams with smaller groups, reflecting the consensus of the participants of this study. Smaller group size was desired as it facilitated discussion, participation in clinical examination and provided enhanced opportunity to receive feedback in a low-key manner. LIMITATIONS Study limitations include the small sample size used (n = 14). However, the literature suggests that twelve interviews is sufficient for data saturation when conducting qualitative research (Guest et al, 2006). Open-ended questions were used during the interview process, but these cannot completely prevent all biases related to researcher-participant factors. CONCLUSIONS This study demonstrates that medical students are highly motivated to take on the role of clinical educators in their professional practice, largely based on their own learning experiences at the bedside. They are aware of the attributes and practices necessary for effective bedside teaching, and the benefits it provides in medical education. Thus, training in the art of clinical teaching in addition to protected time for doctors to engage in teaching, will encourage and enhance educational skills, for the benefit of future generations of medical students and the patients they will care for. Declarations Ethics approval and consent to participate Ethical approval was sought from University of Galway College of Medicine, Nursing and Health Sciences Research Ethics Committee. Following recruitment, written consent was obtained from each of the fourteen participants prior to conducting interviews. Consent for publication Personal date for any of the participants was not used for this research. Participants were informed of the intention to publish the completed research (included in the consent form) and were provided with a copy of their transcript to review, in addition to a copy of the completed research. Consent was not withdrawn by any participants at any stage of the process. Availability of data and materials The datasets/ transcripts used and analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that there are no competing interest in the completion, writing and submission of this original article. Funding The authors did not receive any funding for completion of this research. Authors' contributions Both authors had equal contributions to the data collection, analysis and completion of this research article. Acknowledgements Not applicable. Authors' information (optional) Dr. Catherine Uhomoibhi is a medical doctor with a passion for medical education. Dr. Angela Kearns is GP trained and currently works for University of Galway as a Lecturer in Medicine. References Alpert J.S. (2009) Some thoughts on bedside teaching. The American Journal of Medicine . 122(3). Azer, S (2005) The qualities of a good teacher: how can they be acquired and sustained? 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What experience have you had with feedback – giving or receiving it? Are there differing dynamics depending on the grade of the clinical teacher e.g. Consultant, Registrar, SHO, Intern, clinical Lecturer? What qualities should a good clinical educator have? Can you see a future role for yourself as a clinical educator? What has influenced this? How might you prepare for this? What might prevent you from doing this? Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 18 Dec, 2024 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 05 May, 2024 Reviews received at journal 03 May, 2024 Reviewers agreed at journal 12 Apr, 2024 Reviewers agreed at journal 25 Mar, 2024 Reviews received at journal 20 Mar, 2024 Reviewers agreed at journal 20 Mar, 2024 Reviewers invited by journal 19 Mar, 2024 Editor assigned by journal 19 Mar, 2024 Editor invited by journal 13 Mar, 2024 Submission checks completed at journal 13 Mar, 2024 First submitted to journal 01 Mar, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4004825","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":279304968,"identity":"dca778db-ef4a-4177-9cb3-6e281cf7d467","order_by":0,"name":"Catherine Uhomoibhi","email":"","orcid":"","institution":"Mayo University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Catherine","middleName":"","lastName":"Uhomoibhi","suffix":""},{"id":279304969,"identity":"59e18537-d279-4aed-9458-4bbc6c7560b5","order_by":1,"name":"Angela Kearns","email":"data:image/png;base64,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","orcid":"","institution":"University of Galway, Mayo Medical Academy","correspondingAuthor":true,"prefix":"","firstName":"Angela","middleName":"","lastName":"Kearns","suffix":""}],"badges":[],"createdAt":"2024-03-01 23:19:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4004825/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4004825/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-024-06199-z","type":"published","date":"2024-12-18T15:58:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":52790743,"identity":"435cffc5-69a8-4dfb-8710-09ba6fecc408","added_by":"auto","created_at":"2024-03-15 19:51:43","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":49888,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4004825/v1/15ee71726c48d494a93955f8.png"},{"id":72202536,"identity":"a3313b1a-4562-49ad-a0c4-1c21c7d41543","added_by":"auto","created_at":"2024-12-23 16:14:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":649388,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4004825/v1/43e70cb0-279a-4cbb-aed6-d772d2034bd7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eBedside Teaching – Insights Into the Medical Student Experience and Likely Impact on Future Role as Clinical Teacher\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe benefits of bedside teaching have long been established especially in relation to honing communication skills, clinical skills, history taking and professionalism (Qureshi, 2014). Medical students and doctors are rarely taught how to conduct bedside teaching sessions but are expected to perform the role of clinical teacher once qualified, and frequently discover teaching to be essential to their career development and progression (Cheesman, 2009). Formal education courses exist and are often expensive and seen as time consuming, making them less attractive for busy doctors with significant clinical commitments. Janicik et al (2008) recommends that clinical educators conduct structured sessions with set teaching goals and time limits, but without proper instruction, clinical teaching sessions can often be of variable quality, unpredictable, pitched at the wrong level and involve approaches such as humiliation or intimidation (George et al, 2006). Many doctors therefore, have no formal instruction on how to carry out teaching sessions at the bedside, and are often unaware of strategies to engage learners, while others may be unfamiliar with the clinical curriculum and assessment methods. Furthermore, current evidence suggests that clinical teaching has declined in recent years for a variety of reasons, and novel options such as simulation now provide more controlled patient encounters (Alpert, 2009). The Irish Medical Council (2019) recognises the importance of clinical teaching for future safe patient care, and encourages all doctors to participate as an important component of medical professionalism. In an effort to create a future generation of effective clinical teachers, Qureshi (2014) suggests that development of teaching skills should be incorporated into the undergraduate medical curriculum, while Charnell et al (2018) advocate providing training after graduation and as an integrated part of an induction programme. No such strategies currently exist for our graduates, and there is a general lack of opinion from graduates and students regarding their expectations of and ability to deliver bedside teaching in the clinical environment.\u003c/p\u003e \u003cp\u003eBeing physicians and clinical educators ourselves, it is our understanding that the roles of \u0026lsquo;clinician\u0026rsquo; and \u0026lsquo;teacher\u0026rsquo; to the next generation of doctors in our work are intrinsically linked. However, it can be difficult to fulfil both roles adequately in the context of a challenging hospital environment with many competing interests both in and out of work. From our interactions with other colleagues, we are aware that not every doctor shares the same desire or capacity to teach. We are also cognisant of the additional pressures and challenges faced by female medical students in a traditionally male-dominated field that can impact their learning experiences and desire to be involved in clinical teaching at a later stage.\u003c/p\u003e \u003cp\u003eThus, the purpose of this research was to explore the knowledge, attitudes and planned behaviours of medical students regarding bedside teaching sessions, and whether these experiences have an impact on their future role as clinical educators.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003eA qualitative social constructivist approach (Green \u0026amp; Thorogood, p. 13, 2004) was used to gain direct and unbiased opinions from the study participants, which could be analysed later for emerging patterns or thoughts. It also yielded a narrative report and facilitated the use of participant quotations in the final write-up (Hancock, 2009). In-depth semi-structured one-on-one interviews were carried out using an interview guide with open-ended questioning (\u003cspan refid=\"Sec11\" class=\"InternalRef\"\u003eAppendix 1\u003c/span\u003e). The decision to conduct interviews was considered appropriate for this study as the depth of meaning in relation to bedside teaching was important, and this project was primarily focused on gaining insight and understanding (Newton, 2010).\u003c/p\u003e \u003cp\u003eAll University of Galway final year Medical students based at Mayo University Hospital during the study period (March and April 2020) were initially invited via email to take part in the study. A snowball sampling approach was used where initial participants were asked to endorse interest to their peers who could also add to the study. This was necessary to gain sufficient numbers due to the students\u0026rsquo; varying schedules whilst on clinical rotations. An information sheet indicating the purpose of the research was provided and confidentiality was guaranteed.\u003c/p\u003e \u003cp\u003eConfidential interviews were audio-recorded to facilitate subsequent transcription and analysis of results. An interpretative phenomenological approach and inductive analysis were used to organise the data from participants\u0026rsquo; individual responses into emergent themes and sub-themes about their experiences and perspectives (Smith et al, 1999). Ethical approval was sought from University of Galway College of Medicine, Nursing and Health Sciences Research Ethics Committee. Following recruitment, informed consent was obtained from each of the fourteen participants prior to conducting interviews.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eFourteen final year undergraduate medical students (8 male, 6 female) were interviewed with none of the participants withdrawing consent during or after the research process. Three main themes were identified from the data which were intertwined with the proposed aims of the study (Figure 1). The themes and associated subthemes are outlined below (Tables 1-3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSubthemes and descriptive examples of Theme 1 \u0026ndash; \u003cem\u003ePersonal motivation for being a future clinical teacher\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"992\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTHEME\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSUBTHEMES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePersonal motivation for being a future clinical teacher\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003eA sense of responsibility and reward\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003eMany participants mentioned a sense of responsibility to teach students similar to the way that doctors taught them when they were students, in addition to the personal rewards:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;It\u0026apos;s very much where the people who have gone ahead of you, who are experienced in the profession, that they would then teach the younger people coming through and teach different tips and tricks like any other trade\u0026rdquo;\u003c/em\u003e (P2)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;It\u0026apos;s personally rewarding when you feel like you\u0026apos;re educating the next group and then another part would be whenever you teach something, you reinforce it in your own learning and you get to know something better by them asking you questions. It makes you think of things in different ways, it\u0026apos;s also good for your own development and learning of a topic\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P2)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;\u003cem\u003eI think it\u0026apos;s important to give back because there\u0026apos;s all these people throughout my medical education that gave their time freely to me, so I think it\u0026apos;s important to give back to the younger generations and help them\u0026rdquo; (P6)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003ePositively contributing to student learning \u0026amp; experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eParticipants revealed a desire to contribute to the education of the younger medical students in an effort to help prepare them for the many challenges ahead of them in Medicine:\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;\u003cem\u003eI\u0026apos;ve never always been the smartest or the genius in the room or in the group, or in a bed side, and I felt sometimes left behind, whereas I\u0026apos;ve had experiences with teachers, to them it didn\u0026apos;t matter that one person shone, but that everybody got it, and everybody came up to that standard where they could be safe doctors.\u0026rdquo;\u003c/em\u003e (P1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I want to become the kind of tutor that makes students feel comfortable, and makes the learning environment safe and not stressful, because I have often found bedside tutorials to be sort of daunting... You don\u0026apos;t know what you\u0026apos;re going into and don\u0026apos;t know what you will be get asked... So I want to be the tutor that makes students feel like they can actually learn anything\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003ePromotion of a culture of support for students\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eFrom their personal experiences as medical students, participants appreciated those teachers who were supportive of them regardless of their rank in the class and were determined to act in a similar role for their future students:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I\u0026apos;d really like to be a part of our culture of courage, culture that motivates, that promotes healthy learning, that promotes learning and growing, not just knowing everything today, but continually growing, continually improving, and I really like to just journey with students who may not be the stars, but just to be there for them and teach them...\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P1)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSubthemes and descriptive examples of Theme 2 \u0026ndash; \u003cem\u003eInfluence of undergraduate experiences on role as future clinical teacher\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"992\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTHEME\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSUBTHEMES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eInfluence of undergraduate experiences on role as future clinical teacher\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003eEffective learning\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003eLearners learn more successfully when new knowledge and skills are applicable to real life situations, and when they are provided with opportunities to enhance their practical skills and develop critical thinking through active learning (Karge et al, 2011). This was echoed by the participants in this study:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;If the patient had a murmur she would get every single one of us to listen to it and make sure that we heard it..... The kind of stuff that you hear about, you read about in books, but you might not necessarily understand, and she made sure that every person in the group understood what it was before she moved on to the next thing, which I found very good\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P3)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I remember doing an abdominal exam, she would be literally there with you, making sure that you palpated it correctly\u0026rdquo;\u003c/em\u003e(P7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I just felt that it was kind of my first time seeing a patient like that on the wards, and I just felt it was very good. There was a lot of signs to look out for and how you could approach it and just be more comprehensive\u0026hellip;\u0026hellip;I went in knowing very little but came out having a very good knowledge\u0026hellip;\u0026rdquo;\u003c/em\u003e(P8)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003eUnhelpful occurrences at clinical teaching sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eOne participant described the experience of being subjected to inappropriate and poor clinical teacher behaviour:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;All of us just felt so embarrassed because he made comments such as \u0026ldquo;how on earth do you not know this... this is first year anatomy, this is absolutely ridiculous. Who is your tutor?\u0026rdquo; And then you start to feel really, really... just terrible about yourself. I don\u0026apos;t think that I learned even though he did teach and he did know the information himself, but you just felt talked down to\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;..sometimes people have a lot of knowledge in their head but not all doctors can teach\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think I remember one bedside tutorial where it was with a consultant and the patient was there, and he was very harsh on the students and it got to the point where the patient got very awkward because he started to feel bad for the students. There was just not a nice vibe surrounding it as a whole because even the patient realized it was not very nice and his co-operation started to get less\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;It was a group of about 6 or 7 of us and we didn\u0026apos;t get much hands-on experience. He would also throw random questions at people, so everyone was on edge. And if they got the question wrong, they were embarrassed. You end up focusing more on not messing up, as opposed to learning, so as not to embarrass yourself...\u0026rdquo;\u003c/em\u003e (P12)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003eClinical teachers as Role Models\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eRole models inspire and motivate those working with them to grow and develop in order to achieve their full potential (Azer, 2005). Many participants identified such attributes in their clinical teachers:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Your tutors who are also doctors, they show different ways of communicating to the real patient, different ways of reaching the patient, of asking them to do certain things\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;a lot of the people as students, you\u0026apos;d look up to are the people that take the time to spend with you and to teach you, especially the consultants\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P6)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;So I think a good clinical educator will definitely affect how a student perceives him/herself as a doctor\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P11)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Having really good educators, doctors or tutors. You would leave a tutorial thinking \u0026apos;God, I\u0026apos;d like to be like them. I\u0026apos;d like to have that likability, confidence and knowledge\u0026apos;. And not even just knowledge, but the ability to impart that knowledge to others. It\u0026apos;s very impressive. When you leave a tutorial like that, it is quite inspiring. The great tutorials stand out to this day\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P12)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSubthemes and descriptive examples of Theme 3 \u0026ndash; \u003cem\u003eStudent expectations of bedside teaching sessions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"992\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTHEME\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSUBTHEMES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDEFINITION OF SUBTHEMES AND DESCRIPTIVE EXAMPLES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.452165156092649%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eStudent expectations of bedside teaching sessions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.01913393756294%\" valign=\"top\"\u003e\n \u003cp\u003eFeedback\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.52870090634441%\" valign=\"top\"\u003e\n \u003cp\u003eThe provision of feedback to students has been shown to have a positive impact on clinical performance (McKenzie et al, 2017), and this notion resonated deeply with the participants:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;the only thing worse than bad feedback is no feedback\u0026hellip;.\u0026rdquo;\u003c/em\u003e (P5)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I didn\u0026apos;t learn anything. I just, you know, was winging it, getting by, but in an exam you need someone to be like ꞌno that\u0026apos;s why you do thisꞌ...\u0026rdquo;\u003c/em\u003e (P7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lsquo;The reason it was a good bedside tutorial experience was because when he came back into the room, we went over the history, the exam, the management plan, and then we went through what we were missing at the bedside with the patient, what could have been more important to ask, and what signs or symptoms we didn\u0026apos;t see or recognize. So it kind of consolidated the learning all together, and we realized the mistakes we made, and he helped us to improve it, so that the next time we see a patient like that, we have a better approach to it and better understanding.\u0026rsquo;\u0026nbsp;\u003c/em\u003e(P9)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;The feedback is usually the most important part. Just bringing you to a patient, doing an exam and not getting any feedback is not particularly helpful\u0026hellip;\u0026hellip;.. I think it\u0026apos;s important not to sugar-coat things too much either- to tell you what you did well, what you didn\u0026apos;t do well, and what you need to improve on, and not anything personal or extreme like \u0026apos; you\u0026apos;re really poor\u0026apos; or \u0026apos;this is not acceptable\u0026apos;. Instead, just saying things like \u0026apos;You need to improve this for when you\u0026apos;re working\u0026apos;. I think that\u0026apos;s the most important type of feedback\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P10)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003eTeacher attitude/ behaviour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eGood clinical teachers are excellent communicators, enthusiastic for teaching and are respectful towards the students (Goldie et al, 2015). This resonated with many of the participants:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;they have an encouraging attitude, they\u0026apos;re willing for everybody to learn\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P1)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Someone that can communicate well with patients. If a patient trusts the educator and knows what the main goal of this is, and why they\u0026apos;re helping, and can explain clearly to the patient the benefit of this, the patient interacts well with the students too, and I suppose being kind, and someone you can trust as well so that there is confidentiality there\u0026rdquo;\u003c/em\u003e (P4)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;She was a really encouraging. She\u0026apos;d say, ꞌGood what could that be a sign of?\u003c/em\u003eꞌ\u003cem\u003e\u0026nbsp;So it wasn\u0026apos;t just kind of encouraging, it wasn\u0026apos;t a dead pan stare, and she was saying\u0026hellip;.ꞌOkay, good. Now we will move on to thisꞌ\u003c/em\u003e (P5)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Patience, because the student will get things wrong or may be slow or not know certain answers. You can\u0026apos;t expect them to be perfect\u0026rdquo;\u003c/em\u003e (P12)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u0026ldquo;I think they should be just nice if someone messes up or doesn\u0026apos;t know, and just kinda move on and not embarrass the student or focus on them. Or if they can tell that someone is shy and they don\u0026apos;t want to answer, then maybe stay away from them\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P14)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003eStructured sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eLearners preferred organized teaching sessions with a clear purpose, defined teaching points and relevant learning outcomes:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;..a tutor needs to take enough preparation to be like ꞌthis is the topic we\u0026apos;re doing, this is what I want to ask, these are the things you should be looking forꞌ\u0026hellip;\u0026hellip;\u0026hellip;.and has examined the patient in advance, that they haven\u0026apos;t just gone to the Nurses station saying \u0026ldquo;can I have a Resp patient\u0026rdquo; because then they\u0026apos;re as lost as the people that don\u0026apos;t know the diagnosis. And they don\u0026apos;t know where they\u0026rsquo;re going\u0026rdquo;\u003c/em\u003e (P5)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;One tutor, she had like five or six names every time, so if one was gone she knew another one, she knew the story with all of them so we were never left high and dry, whereas another tutor, never had any one prepared, and would be like ꞌstudents find people for the student thingꞌ and then that one patient would be gone or something, and then it would be like a car crash\u0026rdquo;\u003c/em\u003e (P7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think it\u0026apos;s important to go in knowing what you want the students to learn, some learning outcomes, all that kind of stuff, and generally, the poorer ones I\u0026apos;ve have tended to kind of struggle to get... to communicate what they want the students to know.\u0026rsquo;\u0026rsquo;\u003c/em\u003e(P6)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"18.389553862894452%\" valign=\"top\"\u003e\n \u003cp\u003eGroup size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"81.61044613710555%\" valign=\"top\"\u003e\n \u003cp\u003eAll participants preferred smaller groups of students as larger groups were repeatedly viewed as a major barrier to learning.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes performance anxiety kicks in in bigger groups\u0026hellip;\u0026hellip;..sometimes the patient themselves get performance anxiety, they don\u0026apos;t give a good history if they\u0026apos;re nervous or self-conscious\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P4)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;There were too many students, I think that limited the scope of improving your knowledge and asking questions with the patient. We couldn\u0026apos;t really conduct it appropriately, so it wasn\u0026apos;t really beneficial for us\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P9)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;So if there could be a way to keep it in smaller groups so everyone gets a chance\u0026rdquo;\u003c/em\u003e(P13)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;If you have a small size like three or four, and you can really go in depth then and get to know what each person\u0026apos;s strength and weaknesses are, whether they\u0026apos;re with communication, whether it\u0026apos;s confident, whether it\u0026apos;s knowledge, when it\u0026apos;s practical skills, \u0026apos;cause all those can be tested and evaluated in a bedside teacher\u0026rdquo;\u0026nbsp;\u003c/em\u003e(P1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026lsquo;\u0026lsquo;I think smaller numbers works better, and that\u0026apos;s why sometimes if we went in twos or threes I felt it was just a better learning experience because you were asked more questions, you got to do more of the exam and obviously that\u0026apos;s kind of more beneficial in terms of the examinations\u0026rsquo;\u0026rsquo;\u0026nbsp;\u003c/em\u003e(P8)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe results of this study highlight a varied range of experiences with bedside teaching, but depict a generally favourable view by medical students towards clinical bedside teaching and the desire to become clinical educators in the future. Key insights from this study are as follows:\u003c/p\u003e\n\u003ch3\u003ePersonal motivation for being a future clinical teacher\u003c/h3\u003e\n\u003cp\u003eOur research illustrates how medical students recognise a variety of personal benefits to combining the future roles of both doctor and teacher. Previously echoed in the literature (Dahlstrom et al, 2005; Steinert \u0026amp; MacDonald, 2015), our participants reported a sense of fulfilment and altruism as key motivators to helping learners learn. These factors coupled with a reported obligation to teach junior colleagues, convey an element of gratitude for the positive undergraduate learning experiences they themselves encountered, and many identified teaching as a form of recompense for their own training. Other contributors highlighted their intention to cultivate an inclusive and supportive learning environment in order to inspire and motivate all future learners, clearly recognising the importance of creating a psychologically safe atmosphere to maximise enjoyment in learning (Greenberg, 2016). Not surprisingly, Von Below et al (2018) indicate that Junior doctors are appropriate and effective clinical teachers, as they are often viewed as amenable and empathic, and have a tendency to best understand the learning needs of medical students, having recently been in that position themselves.\u003c/p\u003e\n\u003ch3\u003eInfluence of undergraduate experiences on role as future clinical teacher\u003c/h3\u003e\n\u003cp\u003eThis study clarifies how experiences as an undergraduate can inspire medical student confidence and motivation to be a future clinical teacher, particularly if clinical interactions were constructive and supportive. It is important to note that not all doctors are capable teachers even when armed with excellent medical knowledge, as some engage in inappropriate behaviours and teach by humiliation. Colenbrander (2020) reminds us that such practices still persist and many participants in this study reported witnessing or being subjected to intimidating teaching styles. Such encounters inevitably served as a valuable lesson for our participants on how not to teach, ensuring a determination to do better when they themselves are in the role of clinical teacher. Learning is an active process and for an effective teaching session to progress, the learning needs of the students must always be taken into account (Karge et al, 2011). Many participants recalled accounts of enjoyable learning experiences, where they were able to hone their history-taking and clinical skills under Lecturer supervision, and enhance their critical thinking through reflection on the case encountered. During such learning events, knowledge was consolidated and learners were able to appreciate skills applicable to the real life clinical setting, and their future role as doctors.\u003c/p\u003e \u003cp\u003eMany participants cited being impressed by excellent teachers, whom they considered as role models. Wright (1997) informs us that clinical skills, personality and teaching ability are the most notable attributes of clinical teachers who are considered as role models by medical students. In addition, providing a positive learning environment, having a steady awareness of the curriculum and an ability to incorporate the learning needs of the students, feature readily as essential characteristics for role models in medical education (Burgess, 2016). Several participants were aware of the enjoyment and contentment experienced by doctors in their role as teacher, and were conscious of the ease of learning from such individuals. This led to many participants being inspired to consider their own potential contribution to medical education in the future, in order to facilitate the development of future competent doctors delivering safe patient care.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStudent expectations of bedside teaching sessions\u003c/h2\u003e \u003cp\u003eIn addition to the various attributes of effective teachers, the ability to provide feedback is consistently favoured by medical students in order to exact improvement in their performance (Gray et al, 2017). Such sentiments were reiterated by our participants who preferred constructive feedback-in-action that was readily provided at each clinical teaching session. Some participants placed a greater value on teachers who made corrections with a focus not just on formal assessments, but on the learners working effectively and competently as future doctors. In addition to helpful comments, participants appreciated being treated with respect by kind, patient, compassionate teachers, who excelled in providing encouragement to allow learners to grow into their future professional roles.\u003c/p\u003e \u003cp\u003eParticipants had very clear expectations of their teachers, preferring structured organised sessions with clear learning objectives, yet it is interesting that they cited time pressures as one of the main barriers to their own teaching intentions once working as doctors. In an effort to address this, teaching hospitals will need to invest in practical solutions such as protected teaching times for practicing doctors involved in education. Group size also featured as a concern for many participants. Cooper et al (1983) reported a trend for better performance in physical exams with smaller groups, reflecting the consensus of the participants of this study. Smaller group size was desired as it facilitated discussion, participation in clinical examination and provided enhanced opportunity to receive feedback in a low-key manner.\u003c/p\u003e \u003c/div\u003e"},{"header":"LIMITATIONS","content":"\u003cp\u003eStudy limitations include the small sample size used (n\u0026thinsp;=\u0026thinsp;14). However, the literature suggests that twelve interviews is sufficient for data saturation when conducting qualitative research (Guest et al, 2006). Open-ended questions were used during the interview process, but these cannot completely prevent all biases related to researcher-participant factors.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThis study demonstrates that medical students are highly motivated to take on the role of clinical educators in their professional practice, largely based on their own learning experiences at the bedside. They are aware of the attributes and practices necessary for effective bedside teaching, and the benefits it provides in medical education. Thus, training in the art of clinical teaching in addition to protected time for doctors to engage in teaching, will encourage and enhance educational skills, for the benefit of future generations of medical students and the patients they will care for.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was sought from University of Galway College of Medicine, Nursing and Health Sciences Research Ethics Committee. Following recruitment, written consent was obtained from each of the fourteen participants prior to conducting interviews.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePersonal date for any of the participants was not used for this research. Participants were informed of the intention to publish the completed research (included in the consent form) and were provided with a copy of their transcript to review, in addition to a copy of the completed research. Consent was not withdrawn by any participants at any stage of the process.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe datasets/ transcripts used and analysed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are \u003cu\u003eno\u003c/u\u003e competing interest in the completion, writing and submission of this original article.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive any funding for completion of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoth authors had equal contributions to the data collection, analysis and completion of this research article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information (optional)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr. Catherine Uhomoibhi is a medical doctor with a passion for medical education.\u003c/p\u003e\n\u003cp\u003eDr. Angela Kearns is GP trained and currently works for University of Galway as a Lecturer in Medicine.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAlpert J.S. (2009) Some thoughts on bedside teaching. \u003cem\u003eThe American Journal of Medicine\u003c/em\u003e. 122(3).\u003c/li\u003e\n \u003cli\u003eAzer, S (2005) The qualities of a good teacher: how can they be acquired and sustained? \u003cem\u003eJ R Soc Med\u0026nbsp;\u003c/em\u003e98(2): 67-69 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079387/\u003c/li\u003e\n \u003cli\u003eBurgess, A., Oates, K., Goulston, K. (2016). Role modelling in medical education: the importance of teaching skills. The Clinical Teacher. 13: p 134-137\u003c/li\u003e\n \u003cli\u003eCarlos, W.G., Kritek, P.A., Clay, A.S., Luks, A.M., Thomson, C.C. (2016). Teaching at the bedside \u0026ndash; maximal impact in minimal time. \u003cem\u003eAnnals of American Thoracic\u003c/em\u003e \u003cem\u003eSociety\u003c/em\u003e. 13(4): 545-548.\u003c/li\u003e\n \u003cli\u003eCharnell, A., Stephenson, L., Scales, M. (2018) Training student doctor to become educators. \u003cem\u003eBritish Journal of Medical Practitioners\u003c/em\u003e. 11(1): a1103\u003c/li\u003e\n \u003cli\u003eCheesman, N. (2009) Doctors as teachers. \u003cem\u003eBritish Medical Journal\u003c/em\u003e. 338: b1551\u003ccite\u003e. Accessed from:\u0026nbsp;\u003c/cite\u003ehttps://www.bmj.com/content/338/bmj.b1551\u003c/li\u003e\n \u003cli\u003eColebrander, L., Causer, L., Haire, B. (2020). \u0026lsquo;If you can\u0026rsquo;t make it, you\u0026rsquo;re not tough enough to do medicine\u0026rsquo;: a qualitative study of Sydney-based medical students\u0026rsquo; experiences of bullying and harassment in clinical settings. \u003cem\u003eBMC Medical Education\u003c/em\u003e. 20: 86\u003c/li\u003e\n \u003cli\u003eCooper D, Beswick W, Whelan G. (1983) Intensive bedside teaching of physical examination to medical undergraduates: evaluation including the effect of group size. \u003cem\u003eMedical Education\u003c/em\u003e 17:311\u0026ndash;5\u003c/li\u003e\n \u003cli\u003eDahlstrom, J, Dorai-Raj, A, McGill, D, Owen, C, Tymms, K, Watson, DA (2005) What motivates senior clinicans to teach medical students? \u003cem\u003eBMC Medical Education. 5:27.\u0026nbsp;\u003c/em\u003eAvailable from: https://pubmed.ncbi.nlm.nih.gov/16022738/\u003c/li\u003e\n \u003cli\u003eGeorge, C. (2006) Doctors as teachers. \u003cem\u003eBMA Science \u0026amp; Board of Medical Education\u003c/em\u003e. Available from: https://warwick.ac.uk/fac/sci/med/study/ugr/mbchb/societies/slime/products/teaching/doctors_as_teachers_bma_sept_06.pdf\u003c/li\u003e\n \u003cli\u003eGoldie, J., Dowie, A., Goldie, A., Cotton, P., Morrison, J. (2015) What makes a good clinical student and teacher? An exploratory study. \u003cem\u003eBMC Medical Education 15(40)\u003c/em\u003e Available from: file:///C:/Users/0113577s/Downloads/s12909-015-0314-5.pdf\u003c/li\u003e\n \u003cli\u003eGray, D., Cozar, O., Lefroy, J. (2017) Medical students\u0026rsquo; perceptions of bedside teaching. \u003cem\u003eClinical Teacher.\u003c/em\u003e14(3):205-210. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27146335\u003c/li\u003e\n \u003cli\u003eGreen, J., Thorogood, N. (2004) \u003cem\u003eQualitative Methods for Health Research.\u003c/em\u003e Sage Publication, London.\u003c/li\u003e\n \u003cli\u003eGreenberg, L. (2016). Establishing Trust by Establishing a Safe Learning Environment. Academic Medicine. 91(9) p 1193\u003c/li\u003e\n \u003cli\u003eGuest, G., Bunce, A., \u0026amp; Johnson, L. (2006) How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability. \u003cem\u003eField Methods\u003c/em\u003e. 18(1), pp.59-82.\u003c/li\u003e\n \u003cli\u003eHancock, B., Ockleford, E., Windridge, K. (2009). An introduction to Qualitative research. \u003cem\u003eNational Institute for Health Research Resource pack.\u0026nbsp;\u003c/em\u003eAvailable from: http://www.rds-yh.nihr.ac.uk/wp-content/uploads/2013/05/5_Introduction-to-qualitative-research-2009.pdf\u003c/li\u003e\n \u003cli\u003eIrish Medical Council (2016) Guide to Professional Conduct and Ethics for Registered Medical Practitioners. 8\u003csup\u003eth\u003c/sup\u003e Edition.\u003c/li\u003e\n \u003cli\u003eJanicik RW, Fletcher KE. (2003) Teaching at the bedside: a new model. \u003cem\u003eMedical Teacher\u003c/em\u003e 25(2):127-30. doi: 10.1080/0142159031000092490. PMID: 12745518.\u003c/li\u003e\n \u003cli\u003eKarge, B.D, Phillips, K.M., Jessee, T., McCabe, M. (2011) Effective strategies for engaging adult learners. \u003cem\u003eJournal of College Teaching and Learning\u0026nbsp;\u003c/em\u003e8(12). Available from: file:///C:/Users/0113577s/Downloads/Effective_Strategies_For_Engaging_Adult_Learners.pdf\u003c/li\u003e\n \u003cli\u003eMcKenzie S, Burgess A, Mellis C. (2017) Interns reflect: the effect of formative assessment with feedback during pre-internship. \u003cem\u003eAdv Med Educ Pract\u003c/em\u003e. 8:851\u0026ndash;856. 2.\u003c/li\u003e\n \u003cli\u003eNewton, N (2010). The use of semi-structured interviews in qualitative research: strengths and weaknesses. Available from: http://bristol.academia.edu/NigelNewton\u003c/li\u003e\n \u003cli\u003eQureshi, Z. (2014) Back to the bedside: the role of bedside teaching in the modern era. \u003cem\u003ePerspect\u003c/em\u003e \u003cem\u003eMed Edu\u003c/em\u003e 3: 69-72. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976484/pdf/40037_2014_Article_111.pdf\u003c/li\u003e\n \u003cli\u003eSteinert, Y., MacDonald, M.E. (2015). Why Physician Teach: giving back by paying it forward. Medical Education 49(8) p773-782.\u003c/li\u003e\n \u003cli\u003eSmith, J.A., Jarman M. \u0026amp; Osborn, M. (1999) Doing Doing Interpretative Phenomenological Analysis. In M. Murray K. Chamberlain (Eds.) Qualitative Health Psychology: Theories and Methods, Sage, London, 218-241.\u003c/li\u003e\n \u003cli\u003eVon Below, B., R\u0026ouml;djer, S., Mattsson, B., Hange, D., Wahlqvist, M. (2018). What factors motivate Junior doctors to engage as clinical tutors? A qualitative study. International Journal of Medical Education. 9; 151-157\u003c/li\u003e\n \u003cli\u003eWright, S., Wong, A., Newill, C. (1997). The Impact of Role Models on Medical Students. JGIM 12 p53-56\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Appendix 1","content":"\u003cp\u003e\u003cstrong\u003eQuestionnaire/ Interview Guide:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eWhat do you know about the role of a doctor as an educator?\u003c/li\u003e\n \u003cli\u003eWhat experience do you have with bedside tutorials so far?\u003c/li\u003e\n \u003cli\u003eHow do you prepare in advance of a bedside tutorial?\u003c/li\u003e\n \u003cli\u003eHow have bedside tutorials been of benefit to you?\u003c/li\u003e\n \u003cli\u003eDo you know of any barriers to bedside tutorials?\u003c/li\u003e\n \u003cli\u003eTell me about a good bedside tutorial experience and why was it good?\u003c/li\u003e\n \u003cli\u003eTell me about a poor bedside tutorial experience and why was it poor?\u003c/li\u003e\n \u003cli\u003eWhat experience have you had with feedback – giving or receiving it?\u003c/li\u003e\n \u003cli\u003eAre there differing dynamics depending on the grade of the clinical teacher e.g. Consultant, Registrar, SHO, Intern, clinical Lecturer?\u003c/li\u003e\n \u003cli\u003eWhat qualities should a good clinical educator have?\u003c/li\u003e\n \u003cli\u003eCan you see a future role for yourself as a clinical educator? What has influenced this? How might you prepare for this? What might prevent you from doing this?\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Medical students, undergraduate education, clinical teacher, bedside teaching.","lastPublishedDoi":"10.21203/rs.3.rs-4004825/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4004825/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cu\u003eBackground\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eMedical students and doctors are rarely taught how to be educators but are expected to perform the role of clinical teacher once qualified (Cheesman, 2009). Evidence suggests that clinical teaching has declined in recent years for a variety of reasons (Alpert, 2009), while clear benefits exist when it is done well, particularly concerning history-taking and communication skills. Qureshi (2014) suggests that development of teaching skills should be incorporated into the undergraduate medical curriculum, while Charnell et al (2018) advocate providing training after graduation and as an integrated part of an induction programme. No such strategies currently exist for our graduates, and there is a lack of opinion regarding their expectations and ability to deliver bedside teaching.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eMethods\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis qualitative study sought to explore the varied experiences of doctors with regards to bedside teaching, and the influence such encounters may have on their future potential role as educator. In-depth interviews were conducted with fourteen final year medical students to gain a detailed understanding. An interpretative phenomenological approach was used for data analysis to organise the data into themes and sub-themes.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eResults\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eMedical students identified a range of affirmative and challenging aspects regarding their undergraduate experiences. All recognized important practices necessary to meet individual learning needs and highlighted the positive impact such experiences would have on their future role as educators. Students preferred receiving constructive feedback as opposed to positive or no feedback at all, and all acknowledged a sense of responsibility towards being a future educator.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eConclusion\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this study suggest that while medical students recognise the role of doctors as clinical educators and strive to fulfil this responsibility based on their own undergraduate experiences, training in the art of clinical teaching would be of benefit to all.\u003c/p\u003e","manuscriptTitle":"Bedside Teaching – Insights Into the Medical Student Experience and Likely Impact on Future Role as Clinical Teacher","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-15 19:51:38","doi":"10.21203/rs.3.rs-4004825/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-05-06T03:49:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-05-03T14:50:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"327435ad-b9c4-4160-a601-2c628adf673b","date":"2024-04-12T05:57:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"8f6d829e-3aac-4c61-a873-618ab28d742e","date":"2024-03-25T10:38:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-20T10:07:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"5a0faa0d-cae6-4b86-abee-736eeb4de557","date":"2024-03-20T08:01:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-03-19T18:26:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-03-19T18:14:04+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-03-13T17:49:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-13T17:44:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2024-03-01T23:17:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"06fe17a6-b475-4778-bb95-af17237d06e2","owner":[],"postedDate":"March 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-12-23T16:08:11+00:00","versionOfRecord":{"articleIdentity":"rs-4004825","link":"https://doi.org/10.1186/s12909-024-06199-z","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2024-12-18 15:58:07","publishedOnDateReadable":"December 18th, 2024"},"versionCreatedAt":"2024-03-15 19:51:38","video":"","vorDoi":"10.1186/s12909-024-06199-z","vorDoiUrl":"https://doi.org/10.1186/s12909-024-06199-z","workflowStages":[]},"version":"v1","identity":"rs-4004825","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4004825","identity":"rs-4004825","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}