Effectiveness of non-bedside teaching during the COVID-19 pandemic: a quasi-experimental study

Abstract

Background The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to foster practical clinical skills. In this context, we aimed to address the question, whether presence-based teaching formats without patient involvement are suitable to teach practical skills. Methods In this quasi-experimental study, presence-based teaching formats with and without patient contact were retrospectively compared regarding their effects on medical students’ theoretical knowledge and practical skills, i.e. the performance and clinical interpretation of the neurological exam. To this end, evaluations from 102 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and April 2021 were obtained. Students were initially randomly assigned to course dates. However, 53 students assigned to courses in November and December 2020, were not able to go bedside due to contact restrictions. These students formed the interventional group and the remaining 49 students the control group. The primary outcome measures were students’ overall grading of the course (school grades, 1–6) as well as ratings of knowledge and skills provided by the students themselves and their lecturers on a numerical rating scale (0–10). Comparison between groups was performed using frequentist and Bayesian t-statistics. Results The teaching format without patient contact received a significantly poorer overall grade by the students (p = 0.018). However, improvements in the students’ self-ratings of knowledge and skills did not differ between the two formats (all p > 0.05, BF10max = 0.42). Moreover, especially practical skills were even rated significantly better in the group without patient contact by the lecturers (p < 0.001). Conclusions Teaching formats without patient contact are less well-received by the students. However, they are able to teach practical skills regarding the performance and clinical interpretation of examination techniques. Still, the evaluations obtained might not adequately capture the importance of bedside teaching in preparing future physicians for their practice. Perspectively, hybrid teaching approaches including flipped-classroom concepts hold considerable potential to enhance effectiveness of bedside teaching in the present pandemic situation and in the future.

The European Conference on Education 2022: Official Conference Proceedings

“…In another research, while analyzing the impact of face-to-face teaching in addition to electronic learning, Currat et al (2022) showed that live teaching improved skill acquisition and enhanced skill retention. Contrary to the stated finding, another study (Heitmann et al, 2022) examined the lecturer ratings of student's theoretical knowledge and practical skills in two clinical teaching formats, with and without patient contact, where the group without patient contact was rated significantly better by the lecturers. On the other hand, students expressed negative views on teaching format without patient contact and commented that lack of contact with patient during the course hampers their ability to apply the practical skills acquired in a clinical context.…”

Live video streaming of neurology ward rounds for undergraduate medical students can replace conventional bedside teaching

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Knowledge and confidence levels improvement among obstetrics residents regarding caesarean section training using video-mannequins combination

“…They experienced a limited session of clinical supervision from lecturers [ 16 ]. As a result, this phenomenon significantly causes medical students to get lower grades than expected grades [ 17 ].…”

“…They experienced limited session of clinical supervision from lecturers 16 . Consequently, this phenomenon signi cantly affected to the less grade of medical students 17 .…”