Teaching Medical Students and other Learners John Brill

Teaching Medical Students and other Learners John Brill, MD, MPH 12/29/04

Goals Be able to state five ‘rules’ for precepting n Feel more comfortable and effective precepting students n Enhance students’ learning experience and performance n

Scenario One The First Steps

What Went Well?

What Didn’t ?

Preceptor’s Roles n n n n Evaluator: Assess knowledge Instructor: Convey information Doctor: Patient well-being and comfort Colleague: Want to be liked/respected Business person: Do it without significant loss of productivity Mentor: Role Model Recruiter: Convey enthusiasm for family medicine and program

Andragogy: Adult Learning respect for the adult learner n recognition of the learner's abilities and building on them n focusing on what can be used immediately n building in opportunities to practice new skills and the implementation of new knowledge n

"GNOME“ Setting Goals n Assessing Needs n Determining specific Objectives n Selecting appropriate Methods and teaching strategies n Evaluating outcomes (attainment of objectives) n

Scenario Two Staffing

What Went Well?

What Didn’t ?

The “ 1 -Minute Preceptor” Get a Commitment n Probe for Supporting Evidence n Teach General Rules n Reinforce what was done right n Correct Mistakes n

Scenario Three Discussion

What Went Well?

What Didn’t ?

Lesky L, Hershman WY. Practical approaches to a major educational challenge: training students in the ambulatory setting. Arch Intern Med 155: 897904, 1995. 1) understand the student's starting point n 2) explicitly clarify learner's expectations n 3) provided graduated independence n 4) seek opportunities for meaningful contributions to patient care n

Irby DM. What clinical teachers in medicine need to know. Academic Medicine 69: 333342, 1994. n n n n question and involve learners capture attention and have fun connect to broader concepts go to the bedside be practical, relevant, realistic and selective provide feedback meet individual needs use case-based teaching scripts.

Wilkerson L, Armstrong E, Lesky L. Faculty Development for Ambulatory Teaching. JGIM 5(suppl): S 44 -S 53, 1990. n n n 1) establishing and monitoring mutual expectations between teacher and learner, 2) setting limited goals for teaching, 3) asking questions, 4) stimulating self-directed learning, 5) giving feedback, and 6) capitalizing on the power of role modeling.

Scenario Four Giving Feedback

Practice!

Other Resources – Faculty development of pediatric practitioners: complexities in teaching clinical precepting Pediatrics, March, 1996 by Kenneth B. Roberts, Thomas G. De. Witt – June 2004 Family Medicine The One-minute Preceptor: Shaping the Teaching Conversation Jon O. Neher, MD; Nancy G. Stevens , MD, MPH