Revitalizing the bedside teaching: The enduring value of clinical teaching at the patient’s side

INTRODUCTION

Bedside teaching (BST) is the cornerstone of medical education and training. BST is described as the process of active learning in the presence of a patient.^[1] It remains as the unchallenged classroom in the current era of digital simulations, virtual case scenarios, and artificial intelligence (AI) powered diagnostic and learning tools.

Sir William Osler, often considered the father of modern bedside teaching, emphasized that “medicine is learned by the bedside and not in the classroom.”^[2] This timeless principle underscores a truth we cannot ignore: No number of lectures or online modules can replace the experience of observing, interacting with, and learning from real patients. The apprenticeship model of learning in the clinical environment is in vogue for ages and continues to be the most impactful way to cultivate clinical acumen and humanistic approach to patient care. Furthermore, the medical training should help students to ascend in their training ladder from “Knows how” to “Does,” which here refers to “practice”^[3], and push it further in the ladder to help determine their professional identity as Physicians.^[4] Professional identity transforms a physician from someone who can “do” to someone who authentically “is.” However, BST is currently challenged due to time pressures, documentation overload, faculty shortage, patient willingness, language barriers, concerns about confidentiality, and the current large numbers of students.

THE POWER OF PRESENCE

The power of students being present in the clinical environment with patients is that they witness the real-world application of clinical reasoning, communication, compassion, and empathy. The power of “observing” as mentioned by William Osler is exponential in medical and health professional training.^[5]

They learn to pick up subtle signs – facial expressions, the tone of voice, the feel of the touch in examination – that no textbook can fully describe. It’s where empathy is cultivated and professional identity begins to form.^[6] Moreover, bedside teaching reinforces respect for the patient as a central figure in healthcare. It fosters shared decision-making and reminds learners that medicine is not merely about treating diseases, but about healing people. BST promotes learning in the context, imparts clinical skills, and enables students to develop clinical reasoning and diagnostic skills. It provides ample opportunity for role modeling, observing professional behavior, thinking, and effective communication. Bedside is also the arena to learn team work and ethical challenges in patient care.^[7,8]

BARRIERS AND CHALLENGES

The learning triad of BST is the students, clinician tutors and patients. There has been a paradigm shift in BST due to the context of change in the disease patterns, exponential medical knowledge, and ways to acquire it. Faculty attitudes and competencies have changed. They often cite time constraints, large student groups, and administrative burdens as barriers. Patients today are also sicker, more complex, and often more private about their medical issues, making bedside interactions more challenging. Finally, the student’s generations have changed due to technology adoptions and so are their learning goals and expectations.^[9]

Another critical issue is the lack of formal training for clinical teachers. Many faculty members teach as they were taught – without structured guidance, objectives, or feedback – leading to variability in quality and effectiveness.

STRATEGIES FOR REINVENTION

The landscape of clinical teaching is evolving, shaped by both tradition and innovation. While bedside teaching remains a cornerstone of medical education, new strategies are enriching how students learn and apply clinical skills. For instance, simulation-based learning now offers a safe and controlled space where learners can practice procedures and refine decision-making before encountering real patients.^[4] Digital tools such as virtual patient cases and interactive online modules are becoming valuable supplements to in-person learning, especially when revisiting complex clinical scenarios. An often-overlooked aspect is the power of observation. The “Method of Zadig,” described by Belkin and Neelon,^[5] reminds us that diagnostic accuracy often begins with subtle observations – a practice that remains vital at the bedside. Furthermore, communication and empathy, including the therapeutic use of touch,^[6] are now taught with intention through structured encounters and reflective exercises.

Reviving and redesigning bedside teaching requires focused action, innovation, and support at all levels. Structured models such as 1 min Preceptor, SNAPPS and Learner Doctor methods offer frameworks to make teaching efficient and learner-centered. Pre-round huddles, clear role assignments, and focused learning goals can make even brief encounters educationally rich.

Faculty development is equally crucial. Clinicians must be equipped not only to teach but to do so in a way that engages learners, empowers patients, and uses time wisely.

A CALL TO ACTION

Medical educators must reclaim the bedside – not as a relic of the past, but as a dynamic, indispensable platform for future-ready teaching. Institutions must protect and prioritize time for bedside teaching, recognize its value in assessments and promotions, and create environments where both learners and patients feel respected and safe.

Looking ahead, clinical teaching is likely to embrace a more integrated and personalized approach. Technology will continue to play a transformative role, with tools such as AI-driven diagnostic simulations, augmented reality ward rounds, and virtual bedside tutorials helping to overcome limitations of time and space. Competency tracking through dashboards and real-time feedback will allow for more adaptive learning tailored to individual progress. The educator’s role is shifting – from being a transmitter of knowledge to becoming a facilitator of critical thinking and reflection. As Dent and Harden (2001)^[9] and Qureshi (2014)^[10] argue, bridging the gap between learning and doing requires intentional design, mentorship, and an unwavering focus on patient-centered care. The bedside is where medicine comes alive. Let us not allow it to fade into obsolescence.