The construction of power in family medicine bedside teaching

A video observation study

Charlotte E. Rees, Rola Ajjawi, Lynn V. Monrouxe

    Research output: Contribution to journalArticle

    25 Citations (Scopus)

    Abstract

    Introduction Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. Methods A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Results Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Conclusions Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. Discuss ideas arising from this article at 'discuss'
    Original languageEnglish
    Pages (from-to)154-165
    Number of pages12
    JournalMedical Education
    Volume47
    Issue number2
    DOIs
    Publication statusPublished - Feb 2013

    Fingerprint

    video
    medicine
    Teaching
    non-verbal communication
    student
    teacher
    language
    linguistics
    humor
    possession
    asymmetry
    rhetoric
    workplace
    discourse
    interaction
    interview
    health
    learning

    Keywords

    • bedside teaching
    • Power
    • family practice, education
    • CLINICAL TEACHERS

    Cite this

    @article{36ccb63980944eafa353f4cb19cdeb48,
    title = "The construction of power in family medicine bedside teaching: A video observation study",
    abstract = "Introduction Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. Methods A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Results Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Conclusions Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. Discuss ideas arising from this article at 'discuss'",
    keywords = "bedside teaching, Power, family practice, education, CLINICAL TEACHERS",
    author = "Rees, {Charlotte E.} and Rola Ajjawi and Monrouxe, {Lynn V.}",
    year = "2013",
    month = "2",
    doi = "10.1111/medu.12055",
    language = "English",
    volume = "47",
    pages = "154--165",
    journal = "Medical Education",
    issn = "0308-0110",
    publisher = "Wiley",
    number = "2",

    }

    The construction of power in family medicine bedside teaching : A video observation study. / Rees, Charlotte E.; Ajjawi, Rola; Monrouxe, Lynn V.

    In: Medical Education, Vol. 47, No. 2, 02.2013, p. 154-165.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - The construction of power in family medicine bedside teaching

    T2 - A video observation study

    AU - Rees, Charlotte E.

    AU - Ajjawi, Rola

    AU - Monrouxe, Lynn V.

    PY - 2013/2

    Y1 - 2013/2

    N2 - Introduction Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. Methods A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Results Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Conclusions Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. Discuss ideas arising from this article at 'discuss'

    AB - Introduction Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. Methods A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Results Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Conclusions Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching. Discuss ideas arising from this article at 'discuss'

    KW - bedside teaching

    KW - Power

    KW - family practice, education

    KW - CLINICAL TEACHERS

    UR - http://www.scopus.com/inward/record.url?scp=84870002762&partnerID=8YFLogxK

    U2 - 10.1111/medu.12055

    DO - 10.1111/medu.12055

    M3 - Article

    VL - 47

    SP - 154

    EP - 165

    JO - Medical Education

    JF - Medical Education

    SN - 0308-0110

    IS - 2

    ER -