General Teaching Principles

Bedside teaching is viewed by nearly all students as the best way to learn clinical skills; yet, less than half of students feel they have gotten enough bedside teaching in their medical education. Unfortunately, training for faculty in how best to incorporate bedside teaching effectively into a busy workflow to maximize learning outcomes is lacking. Thus, bedside teaching has decreased from 75% of the clinical curriculum in the 1960s to less than 10% today, despite evidence that bedside teaching has been shown to improve clinical skills and diagnosis.

The goal of this module is to provide a brief overview of medical education concepts that are applicable to bedside teaching in emergency medicine (EM) to help improve and hone skills and provide ways to work bedside teaching into the complex and fast-paced EM practice.

Key Takeaways

Adult Learning Theory

Malcolm Knowles believed that adult learning was different than childhood learning for several reasons. He made five key assumptions about these learners that can help us as teachers better shape our approach to bedside teaching.

• Self-Directed: they are independent in that they want to make their own decisions and determine their own learning pathway.
• Experienced: they come with multiple prior experiences which shape how they learn and the lens they view your teaching from.
• Goal-Oriented: their interest in a topic extends only so far as it will help them in their professional or social roles and will disengage in topics they are not interested in.
• Practical: they expect teachings to be problem-based and to have an immediate impact that they can bring to their roles.
• Self-Motivated: their desire to learn is born from internal stimuli, such as job satisfaction, self-esteem, and personal growth.

RIME Framework

A large part of being a teacher is understanding where your learners are, so you can meet them where they are and help them improve. The RIME framework provides terminology for describing the professional growth of trainees.

• Reporter: gathers and reports data.
• Interpreter: assimilates information from history, exam, diagnostic tests to generate a differential using medical knowledge.
• Manager: organizes information and resources to prioritize differential diagnoses and diagnostic and treatment plan using available evidence.
• Educator: articulates what is known, determines what needs to be known, and conveys medical knowledge and its limitations to the patient and colleagues.

Bloom's Taxonomy

In 1956, Benjamin Bloom with collaborators Max Englehart, Edward Furst, Walter Hill, and David Krathwohl published a framework for categorizing educational goals. "Taxonomy of Educational Objectives," familiarly known as Bloom's Taxonomy, is a framework that created a common language such that learning materials could be compared between institutions and provided a way to assess what a curriculum offered within the cognitive learning domain.