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