Teaching in a Busy Practice
Teaching students or residents, while simultaneously taking care of patients is both a rewarding and challenging endeavor. The challenge of clinical teaching (according to Kreger, C. Strategies for efficient teaching in the midst of chaos in Hudson, A. & Watson, D. (Eds.)(2001). The clinical teaching handbook. Columbus, Ohio: The Ohio State University College of Medicine and Public Health) is that it:
- Requires thinking in the midst of action.
- Requires preparedness often without apparent preparation.
- Involves multiple levels of learners.
- Includes multiple roles/agenda for the teacher.
- Occurs with limited time.
- Occurs in multiple sites (bedside, hallway, conference room).
- Occurs often in a setting of little control.
The Five Microskills: Precept with Limited Time
Get a Commitment
- Ask the student "What do you think is going on?"
- What other information would you like?
- What is the differential diagnosis?
Probe for Supporting evidence
- "What are the major findings?"
- What else did you consider?
- What questions do you have?
Teach one general rule
- Prioritize and provide one concise learning point that is exemplified by the case.
Reinforce what was done well
- Ask the learner to self-assess (their interview, presentation, etc.)
- Offer a specific statement about what was done well.
Provide Coaching
- Correct any mistakes.
- Discuss strategies or a plan to improve.