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To study the phenomenon of disease without books is to sail an uncharted sea,
while to study books without patients is not to go to sea at all(Osler, 1903)
THE STRUCTURE OFBEDSIDE TEACHING
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Weekly activity
Mon Tue We Thu Fri Sat
07.00 08.00 PretestPreround on
patients
Preround on
patients
Preround on
patients
Preround on
patients
Preround on
patients
08.00 09.00
BST CRS BST CSS
Grand rounds
BST RPS09.00 10.00
10.00 11.00 Out patients clinic
Ward activity Ward activity Out patients clinic
11.00 12.00
12.00 13.00Meeting with chief
of department
13.00 14.00
14.00 - Night shifts
BST = bedside teaching; CRS = case report session
CSS = clinical science session; RPS = resource person session
Example 1
Example 2
http://g/Mini%20CEX/shands_activity_schedule.pdfhttp://g/Mini%20CEX/va_activity_schedule.pdfhttp://g/Mini%20CEX/va_activity_schedule.pdfhttp://g/Mini%20CEX/shands_activity_schedule.pdf -
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Bedside Teaching
Ideal setting for
Demonstration of Physical findings
Interviewing
Developing interpersonal skills Teacher, Trainee & Patient
interaction
Role-modeling
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KEY STRATEGIES IN BEDSIDE TEACHING
PRE-ROUNDS PREPARATIONPLANNING
ORIENTATION
ROUNDS (20) INTRODUCTIONINTERACTION
OBSERVATION
INSTRUCTION
SUMMARIZATION
POST-ROUINDS (100) DEBRIEFINGFEEDBACK
REFLECTION
PREPARATION
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Case Analysis :
Problem Hypothesis Mechanism Moreinfo
Dont
knowLearningissues
Problem
solving
Decision
Making:
Diagnosistreatment
FINALOBJECTIVES
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Tingkat Kompetensi
Akuisisi
observasi tindakan
Membantu sejawat melakukan tindakan Kompetensi
Melakukan tindakan di bawahpengawasan langsung supervisor
Melakukan tindakan dalam supervisiindirek
Profisiensi
Melakukan tindakan secara mandiri
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Tutorial 1 (PBL)
One or two
students clerkthe patient ontheir own andpresent the
findings to theirgroup inabsence of apreceptor
Step One
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Tutorial 1 (PBL)
Group discuss theproblem and doself / group study tofind out information
related to learningissues
Step Two
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Tutorial 2 (PBL + PBT)
Students meet
their preceptor andmake formalpresentation and
go throughlearning issues.
Step Three
Preceptor, who is an expert clinician, will act as a facilitator and
teacher, as and when appropriate
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Case Report Session
Discussions on patients who have been
seen in previous contact (in BST)
Discuss specific diseases /conditions
according to the modules
Preceptor guides the learning process
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Clinical Science Session
Discuss scientific issues related to topics chosenor assigned to a student or a group of students
Enhances EBM practice in solving clinicalproblem
Things to be discussed within 2 hours ofmeeting: Discuss previous learning issues (30 minutes)
Presentation of new topic + discussion (1 hours) Generating next learning issues (15 - 30 minutes)
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Resource Person Session
Important topics related to the department
Given by the experts
First RPS can be used by the chief ofdepartment to emphasize the importance of
knowing certain topics chosen in dealing with
patients in the setting of primary health
care/family medicine
Encourages active participation of students
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Activity Duration/week Duration in3 weeks
Duration in9 weeks
Bedside
teaching
3 x 2 hours 18 hours 54 hours
Case report
Session
1 x 2 hours 6 hours 18 hours
Clinical
ScienceSession
1 x 2 hours 6 hours 18 hours
Expert
session
1 x 2 hours 6 hours 18 hours
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Mini Clinical Examination
Exercise (Mini-CEX)
ABIM developed and validated the clinical exercise
(CEX) as a method of assessing residents history
taking and physical examination skills
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Mini-CEX forms
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The attending evaluates the students history andphysical examination, clinical judgment, humanism, andoverall clinical competence as a student, using thestandardized mini-CEX form
The form uses a standardized nine-point scale :
- 1-3(unsatisfactory)
- 4 (marginal)
- 4-6(satisfactory)
- 7-9(superior)
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Conclusion :
The benefits of the mini-CEX :
- skills are evaluated in a short time
- the students will receive a feedback
- could be used for observing the student at
the bedside, hear the students assessment
- low cost
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