Bedside teaching is valuable but underutilized. Including the patient, collaborating with learners, faculty development, and promoting a supportive institutional culture can redress several barriers to bedside teaching.

Epidermolysis bullosa is the name given to a group of rare, genetically determined diseases characterized by cutaneous blistering and subsequent scarring. It presents a challenge to the anaesthetist managing patients who often require multiple operations. This review article includes a retrospective audit of cases treated at St Thomas' Hospital between 1993 and 1998. We studied the case notes and anaesthetic records of patients with dystrophic epidermolysis bullosa requiring anaesthesia and recorded the anaesthetic management and complications that occurred. Methods Patients From January 1993 to January 1998, 51 patients with dystrophic epidermolysis bullosa had a total of 306 anaesthetics. The ratio of males to females was 3:2, with an age range of 1-51 yr; 44% were from the UK, while the remainder were from Italy, Serbia, Croatia, Greece and Portugal. Only 12% of the foreign patients spoke English.