Transcript Document

Focus on Education Workshop
Because We’re ALL Educators!
Wednesday May 6, 2015
Clinical Teaching & Precepting of Students and Staff
Joseph G. Sorbello, MSEd, RT, RRT
Associate Professor and Chair
Department of Respiratory Therapy Education
College of Health Professions
SUNY Upstate Medical University
Syracuse, N.Y.
Learning Goals
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List the steps of the One-Minute Preceptor
Model of clinical teaching
Explain how each step fosters effective &
efficient teaching
Demonstrate understanding of the model on a
sample scenario
Integrate the One-Minute Preceptor Model
into your clinical teaching
Making the Most of Teaching Time
How Time is Spent in the Teaching Encounter
Chart Review / Assessment: 6 Minutes
Questioning & Clarifying: 3 Minutes
Discussion & Actual Teaching: 1 Minute
3"
1"
6"
The “One-Minute Preceptor”:
Step Microskills
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Get a Commitment
Probe for Supporting Evidence
Reinforce What Was Done Right
Correct Mistakes
Teach a General Principle
Step 1: Get a Commitment
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Push the learner to move beyond their level of
comfort and makes the teaching encounter more
active and more personal.
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What do you think is going on with this patient?
(top 2 diagnoses)
What laboratory tests do you think we should get?
How do you think we should treat this patient?
What other diagnoses would you consider in this
setting?
For Review
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The purpose of getting a commitment is to:
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A. Gain insight into the learners reasoning.
B. Prove the learner wrong.
C. See how the learner reacts under pressure.
Step 2: Probe for Supporting Evidence
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Hear their thinking. Learn where the gaps are and what
might have been missed.
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What factors in the history and physical support your
diagnosis?
Why would you choose that particular medication?
Why do you feel this patient should be intubated?
What else did you consider?
For Review
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It is important to ask for supporting
evidence at this stage because:
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A. You can determine if the learner had
adequate evidence for the commitment.
B. You need to fish out the lucky guesses.
C. You can correct any faulty inferences.
D. All of the Above.
Step 3: Reinforce What Was Done Right
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Include specific behaviors that demonstrated
knowledge, skills, or attitudes valued by the
preceptor.
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Your diagnosis of ‘probable pneumonia’ was well
supported by your assessment.
Your assessment was well organized.
You included appropriate additional medical history
and medications, as well as response to therapy.
For Review
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Your positive reinforcement need not refer to
specifics as the learner should know what was
well done.
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A. True
B. False
Step 4: Guide Errors / Omissions
Tell them what areas need improvement,
correct errors & omissions or misperceptions.
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In your shift report you mentioned an ABG but did not
report vent settings. Following standard patterns in your
report will help avoid omissions and improve your
communication.
I agree that, at some point, complete PFTs may be helpful,
but right now the patient is acutely ill and results may not
reflect her baseline. We could glean important info with
just a peak flow and a pulse oximeter.
Step 5: Teach a General Principle
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Brief teaching specifically focused to the
encounter can be very effective.
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The key features of this illness are…..
The natural progression of this disease is….
Deciding how someone needs to be ventilated for
ARDS can be challenging. Fortunately there are
some criteria that have been tested which help….
The “One-Minute Preceptor”:
5 + 1 (6) Step Microskills
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Get a Commitment
Probe for Supporting Evidence
Reinforce What Was Done Right
Correct Mistakes
Teach a General Principle
Conclusion
Step 6: Conclusion
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Time management
Definition of roles of the learner and the
preceptor after the teaching encounter
Explain what the next steps will be and what
their role is to facilitate the care of the
patient
Roles and expectations for each person are
made clear in a way that facilitates further
learning & optimal patient care.
Give Learners a Chance!
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Practice Makes Perfect
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Practice is the best of all Teachers
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-Maxim 469 of Publilius Syrus
Practice does not make perfect. Only perfect
practice makes perfect.
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-Proverb
-Vince Lombardi
Students need to now if, and when they are getting it
right! They need feedback!
Planning Your Own Teaching Strategy
What makes sense in your practice?
The First Meeting
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Elicits student’s expectation for the rotation.
Describes expectations of student and format for
supervision.
Ensures mutual understanding and acceptance of
expectations.
Is positive and enthusiastic about the rotation.
References
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Irby, D., *1997, February). The One-Minute Preceptor.
Presented at the annual Society of Teachers of Family
Medicine Predoctoral Meeting, Orlando, FL.
Irby, D. (1997, June). The One-Minute Preceptor:
Microskills for Clinical Teaching. Present at a
teleconference from East Carolina Univ. School of
Medicine, Greenville, NC.
Neher, J.O., Gordon, K.C., Meyer, B., & Stevens, N.
(1992) A five-step “microskills” model of clinical
teaching. Journal of the American Board of Family
Practice, 5, 419-424.
What types of questions do you have?
[email protected]