Patient bedside important for medical student learning

December 7, 2017, Boston Medical Center

A new web-based tool aimed at improving experiential learning for medical students has demonstrated that learning occurs in patient rooms and in other areas within the hospital, including workstations. Developed by clinicians at Boston Medical Center (BMC) and BU School of Medicine, "Learning Moment" allows students to electronically log their learning experiences and share them with their peers. This tool provides an organized way for students to reflect on their learning experiences, which is a critical component of lifelong learning that is sometimes lacking in clinical learning environments.

Learning Moment, which was piloted among third and fourth year rotating through BMC's emergency department, uses data capture to track precisely where learning experiences take place (for example at the bedside or the physician workstation).

With the increasing administrative demands on providers, the study authors noted that the bedside teaching model is thought to have declined in recent years. Thus, their hypothesis was that most of the learning experiences reported by students would occur away from the patient bedside.

Surprisingly, they discovered that the majority of learning moments logged in their study still took place in patient rooms, although there were some differences between students planning for a career in emergency and those who intended to pursue other specialties.

Specifically, researchers found that students who planned to pursue training in emergency medicine reported that while most of their learning moments occurred in patient rooms, a large proportion also took place in workstations, resuscitation rooms and other areas. Conversely, for non-emergency medicine bound students, a large majority of learning moments occurred in , with a much smaller percentage taking place in other areas such as physician workstations.

The authors concluded that the bedside remains an important component of medical education for students entering multiple specialties, despite a reported decline in this teaching modality.

Regardless of the location of learning moments, the creators of Learning Moment hope that it will serve as a tool for optimizing , one that can be adapted to various clinical departments and institutions.

"We hope that our study will highlight the potential of Learning Moment as a tool to foster experiential learning by encouraging reflective observation during practice," said Alexander Sheng, MD, assistant professor of medicine at BU School of Medicine and physician at BMC who is the study's lead author. "The data from Learning Moment has the potential to help educators better understand the intricacies of local learning microenvironments as well as the broader clinical learning ecosystem."

A study based on the initial implementation of this novel program is published online in the Western Journal of Emergency Medicine.

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