The One Minute Preceptor: Maintaining Efficiency While Teaching Jennifer Hagen, MD, FACP Office of Faculty Development University of Nevada, Reno School of Medicine

Learning Objectives Apply the steps of the One Minute Preceptor (OMP) technique Appreciate how OMP allows you to identify knowledge gaps for any level or learner Based on identified gaps, learn to select one teaching pearl for each patient Facilitate self-directed learning using the OMP

Why we like the One Minute Preceptor (OMP): Efficient and effective clinical teaching tool Teaches at the level of each learner Delivers one key learning point Learners identify areas for improvement Guides learners’ to self-directed learning

OMP Steps (Microskills) Get a Commitment Probe for Supporting Evidence Teach General Rules Reinforce What Was Done Right Correct Mistakes Set Learning Goals Neher et al. A Five-Step “Microskills” Model of Clinical Teaching. JABFP 1992; 5: 419-424.

1. Get a Commitment First step after learner’s patient presentation Have early learners commit to a diagnosis What do you think this patient has? As learners progress apply this step to any aspect of patient care Does this patient need to be admitted to telemetry or the ICU? What is the most cost-effective way to approach this diagnostic work-up? Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

Helpful Questions What do you think is going on? How do you plan to find the diagnosis? What is your treatment plan? How are you going to address this situation? For learners unwilling to commit: What would you do for this patient if I wasn’t available? Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

2. Probe for Supporting Evidence This helps you understand how the learner came to his/her commitment The learner should note: Supporting H & P findings Supporting labs/radiology Supporting medical evidence Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

Helpful Questions What factors did you consider in making that diagnosis? What other options did you consider? Would it alter your management if this patient was pregnant? older? younger? etc. Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

3. Teach General Rules Pick one learning point Avoid the temptation of trying to teach everything about each case Pick teaching points generalizable to other cases Example: Although 105 CFU/ml is usually the criteria for urinary tract infection, 102 - 104 CFU/ml may indicate infection in symptomatic patients with pyuria. Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

4. Reinforce What Was Done Right Identify a specific behavior, knowledge or attitude that you would like the student to continue exhibiting Examples: It was good that you included small bowel obstruction in your differential diagnosis. It was good that you did not get defensive when the patient was angry. You demonstrated good sterile technique. You can ask the learner to identify what they think they did well Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

5. Correct Mistakes Effective feedback is: Announced Timely Specific Behavior related Ask the learner to identify what could have been done differently Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

6. Set Learning Goals The student may suggest a reading topic based on your feedback If not prompt the learner – What are you going to read about tonight to learn more about this topic? Close with commitment to discuss at next meeting

Tips for New Professors Plan your teaching points Practice OMP one step at a time Choose areas of focus for the learner Theme for the day/week: physical findings Reinforce what was taught Announce feedback I’m going to give you feedback now Model self-directed learning Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

The One Minute Preceptor Video Please click the link below to watch a 2-minute video of the One Minute Preceptor in action: http://med.unr.edu/ocf/professional-development/maintaining-efficiency This brief video features Dr. Ivan Lopez, Director, Renown Institute for Neurosciences; Professor and Chair, Department of Neurology, University of Nevada, Reno School of Medicine (in the role of Preceptor) and University of Nevada, Reno School of Medicine MSIV Student, Diane Mar (in the role of medical student) as they illustrate the OMP technique. We thank them and our UNR Med-IA team for giving their time to develop this video.

References Neher et al. A Five-Step “Microskills” Model of Clinical Teaching. JABFP 1992; 5(4):419-424. Neher, Stevens. The One-Minute Preceptor: Shaping the Teaching conversation. Family Medicine 2003; 35(6):391-393.

Contact Information For questions about the One Minute Preceptor or Community Faculty Development: Dr. Jennifer Hagen, Associate Dean, Office of Faculty Development jmhagen@med.unr.edu, (775) 784-6758 For questions about the Office for Community Faculty: Dr. April Heiselt, Director, Office for Community Faculty aheiselt@medicine.nevada.edu, (775) 682-8390