More information about text formats
Mulholland et al. make some very important points but I think understate the importance of bedside teaching. The only learning that ever stuck with me as a junior doctor was when it took place in relation to a clinical scenario involving a patient. Nothing has hurt training more than the reduction in exposure to patients either as in-patients or in the out-patient setting. It is an unavoidable consequence of the reduction in working hours but the feedback trainers give to trainees when reviewing patients is still the most important part of their learning. The only problem now is that the trainee is probably not rostered on for the next week.
The importance of this patient interaction is highlighted by the fact that undergraduates are now learning their basic anatomy, physiology etc. in the context of clinical scenarios and meeting real patients. This is a major step forward for undergraduate training and something I am very pleased to be involved in. Unfortunately, in my opinion, post graduate training has gone in the opposite direction and there is not a lot we can do about it other than increasing the length of training programs. The way we now work means that trainees see fewer patients and therefore learn more slowly. We can organise as many study days as we like but it does not compensate for that loss.