The physiologic and psychological effects of the bedside presentation

In teaching hospitals, bedside case presentation is a commonly used form of instruction. A group of students and physicians gather around a hospitalized patient's bed and discuss the case. It is used because it allows the student to inspect the patient's condition and see physician-patient interaction at work. However, for some patients, this interaction has been thought to be very stressful, and it has been suggested that this stress can itself be harmful to the patients, particularly those having critical heart diseases. An anxiety- rating instrument and blood tests were used to evaluate a group of 20 heart patients during bedside case presentations. There were no increases in heart rate or blood concentrations of norepinephrine, a hormone which increases blood pressure. There were slight increases in the average blood pressure during bedside presentations. Subjective findings revealed that patients actually felt "reassured" during the presentations. The patients also felt the physicians "cared more about them" as they discussed their disease. Patients found that they, too, learned more about their illness during the case presentations. The bedside case presentation in teaching hospitals was perceived by the patient as a positive event and did not induce stress using this model for evaluation.