Creating a safe bedside teaching environment: a personal experience

A ctive learning is increasingly used as a teaching method in modern medical curricula. Therefore I have adopted case-based group discussions as an educational method for nephrology bedside teaching. In these sessions the students had first to review the patient’s history from the case record and summarise the important and vital points. This was followed by a group discussion focusing on the management plan during an outpatient consultation or hospital admission. Through the discussions I got to know the students’ thoughts on the management of the case in question and provided them with feedback. The majority of students enjoy case-based group discussions, a fact reflected in the students’ evaluation forms. However, a sizable minority find them stressful which may be directly related to my way of delivering feedback. Sometimes I have a tendency to be too blunt in giving the students any negative feedback and this seems to put them off making further contributions to the session. In searching to learn a better way to give a feedback, I came across an article by Rudolph and colleagues entitled ‘There’s no such thing as ‘‘nonjudgmental’’ debriefing: a theory and method for debriefing with good judgment’ (1). Having read the article I realised the importance of creating a psychological safe teaching environment while challenging the students and engaging them in the discussion. The debriefing model used by Rudolph is based on advocacy and inquiry and giving feedback to the students in a respected way. The following is an example from my own experience: