The Tradition of Daily Bedside Clinical Care

A 2011 study conducted by physicians at Johns Hopkins found that its residents were spending as little as 12 percent of their time in direct content with patients. Another study exposed weakened clinical skills among hospital residents. Together, the findings fueled growing concern that physical exam skills were eroding.

But now Brian Garibaldi, co-president of the Society of Bedside Medicine and contributor to Stanford Bedside Teaching Symposium, and his colleagues at Johns Hopkins University (JHU) are reinvigorating bedside medicine in the university’s residency training program. Through a bedside curriculum called Advancing Bedside Cardiopulmonary Examination Skills (ACE), the team is helping Johns Hopkins return to its roots: William Osler, for whom the residency training program is named, began the tradition of making “bedside clinical care a daily practice” way back in 1889.

Garibaldi says there’s “incredible institutional support” for the effort and that Johns Hopkins wants to be a leader in the physical exam in the 21st century. Already, ACE has been shown to improve the attitudes, confidence and skills of the program’s residents, and alongside ACE, residents participate in a weekly session called Mornings with the Masters, where “an experienced clinician joins the team to model physical exam techniques and bedside interactions.”

Despite the extra time commitment of these interventions, residents say they value physical exam skills and stronger patient interactions. Gigi Liu, one of Garibaldi’s colleagues, says that there’s a “beautiful synergy” between technology and bedside medicine: “When we combine visual findings from the ultrasound with audio (murmurs) and tactile findings (palpations), it’s the most powerful diagnostic and educational tool.”

Stanford Medicine 25 obviously agrees with the emphasis on bedside medicine—it’s one of our cornerstone missions.  And we will host Brian Garibaldi, co-president of the Society of Bedside Medicine, for our 4th Annual Stanford 25 Bedside Teaching Symposium, held September 7 – 8, 2018.

You can read the full Dome article on Johns Hopkins’ bedside teaching efforts here: “A Mission to Reinvigorate Bedside Medicine.”


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