Background: Bedside teaching is central to medical training, yet trainees often report it is underutilized and constrained by clinical demands. Prior local peer-observation studies have examined the quantity and types of teaching techniques from the attending perspective, but little is known about how teaching moments are perceived by residents in real-time during rounds. Although observer assessments have been used to evaluate the educational quality of rounds, it is unclear how closely these reflect the experiences of participating learners, as learners are often engaged in presentations or managing patient care tasks. Given that participating residents must balance learning with patient care responsibilities, and observers can devote more attention to teaching behaviors, the two roles may offer distinct perspectives on bedside instruction for a deeper understanding. This study compares the quantity and types of bedside teaching techniques observed during rounds, as perceived by participating trainees versus observing trainees, to clarify how each role captures teaching provided within the rounding environment.
Methods: This prospective cohort study was conducted at a tertiary children’s hospital from April to August 2025. Prior to the rounds observation phase of the study, residents viewed an educational video on the 11 defined teaching methods being studied. Twenty inpatient rounds led by 16 hospitalists with 59 participating residents were observed. Typical rounding teams included a senior resident (PGY-2 or PGY-3) and 2-3 interns (PGY-1). Each rounds session was observed by a hospital medicine fellow and one of four senior residents on the study team. Observers recorded the number and types of teaching techniques on standardized forms. After rounds, participating residents completed surveys assessing perceived quantity and type of teaching. Descriptive statistics summarized all variables, and non-parametric analyses compared responses between rounding residents and matched observers.
Results: A total of 39 observation forms were completed by observers. Forty-four post-rounds surveys were completed by participating residents (PGY-1: 61%, PGY-2: 16%, PGY-3: 23%). The mean number of teaching points identified by observing resident versus fellow per session were comparable (9.16 vs 10.2, p = 0.23). Among participating residents, 50% reported receiving 6–10 teaching points per rounds, 25% reported 0–5 and 25% reported ≥ 11 teaching points. The most frequently identified techniques by participating residents were broadening, up-the-ladder, and multi-answer/no right answer (Figure 1). Observers most often identified targeting, teaching the team through teaching the family, and multi-answer/no right answer (Figure 2).
Conclusions: Both levels of observers identified ~10 teaching points per session. Participating residents recognized a similar number of teaching moments, most often between 6 to 10 per session. These findings challenge the assumption that learners overlook bedside teaching. Although the overall quantity of teaching was comparable across roles, differences in the specific techniques identified suggest that observers and participants may notice different aspects of teaching. This highlights the need to further explore how cognitive load and clinical responsibilities shape what residents perceive as teaching during rounds.
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