Medical Education

Orientation

  • Orienting the learner to the teacher
    • Who will be the primary supervisor?
    • When is the teacher available? How to contact?
    • How feedback will be provided?
  • Orienting the teacher to the learner
    • Learner level of training, prior experiences
    • Objectives and expectations for the experience
      • Modified Bloom's Taxonomy:
        • Remember
        • Understand
        • Apply
        • Analyze
        • Evaluate
        • Create
  • Orienting the learner to the setting
    • Administrative, system, scheduling, areas

Teaching

Meta-Teaching

  • Goals
  • Needs
  • Objectives
  • Methods
  • Evaluation

Reflective Judgement

  • Pre-reflective:
    • Knowledge from direct, personal observation or from an authority
    • All problems have a correct answer, no uncertainty
  • Quasi-reflective
    • Ill-structured problems exist
    • Not sure how to deal with ambiguity
  • Reflective
    • Knowledge is constructed and can change
    • Criteria for determining the best evidence

Reviewing Clinical Cases

One-Minute Preceptor

  1. Get a Commitment
  2. Probe for supporting evidence
  3. Teach General Rules
  4. Reinforce what was done right
  5. Correct mistakes

SNAPPS

  • Summarize the case including pertinent history, physical, lab, etc...
  • Narrow differential/problem list to top 3
  • Analyse the differential using evidence
  • Probe the preceptor to clarify points that are unclear
  • Plan for treatment, follow-up, consultation
  • Select a learning point (not needed for every case)

Checking In

  • Decrease barriers to learning through a supportive and challenging learning environment
  • Be aware, and address the Learner's emotions and thoughts
  • Effective, meaningful feedback with opportunity for improvement
    1. Observation of student behaviour or work
    2. Prompt student for self-assessment
    3. Nonjudgmental (descriptive) and balanced (positives and negatives) feedback
      • Based on observations, respectful climate, non-judgmental, focus on specifics, focus on behaviours (not personality), goal-based, thoughts/feelings elicted
    4. Ascertain that student understands the difference between current behaviour and desired behaviour
      • Limit to 2-3 points
    5. Elaborate a plan and suggestions for improvement
    6. Follow-up on improvement

Role Modelling

  • Intentional Approach
    • Demonstrating skill/behaviour
    • Commenting on what was done
    • Discussing what was done

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