COMMENTARY Back to the bedside: the role of bedside teaching in the modern era

The Author(s) 2014. This article is published with open access at Springerlink.com Fifty years ago, three-quarters of clinical teaching was at the bedside [1]. Today’s estimates are 8–19 % [2]. This reduced exposure in undergraduate years to a critical aspect of training may be responsible, in part, for the declining clinical skills of junior doctors [3]. Peters and ten Cate [4] have reviewed the literature on bedside teaching, assessing its strengths, the causes of its decline, and its potential role in medical education. Why has bedside teaching declined Hospitals are now busier with significantly increased patient throughput. Teachers are required to see more patients, and fill in increasing amounts of paperwork with no additional time allocated for these tasks. Opportunity and time to teach at the bedside is more limited. Senior teachers may feel under-prepared for teaching students who have a radically different undergraduate course to the ones they experienced, whilst junior staff who may have a better grasp of the new-style curricula have limited teaching opportunities. Bedside teaching is also in competition with other teaching modalities that are easier to plan, including rapidly developing clinical simulation techniques, often as part of clinical skills centres. Students feel more comfortable with the possibility of making mistakes around simulated patients. They also have the advantage of direct feedback from the actor, and the opportunity for repetition of difficult scenarios. There has been a paradigm shift in clinical diagnosis. There is an increasing dependence on sophisticated technology and laboratory tests rather than clinical examination skills fostered at the bedside. This philosophy has resulted in a partial shift of ward rounds from the bedside to the conference room, where bedsid