Teaching and Learning with our Peers

Which do you agree with most? Line up I learn best on the job? I learn best in a lecture?

Learning Objectives Understand the approach to teaching and learning used on the GP scheme Understand some educational theory Effectively plan your presentations / teaching sessions Learn different teaching methods and develop confidence to adapt to personal style Develop skills to keep your teaching interesting and effective Learn about giving and receiving feedback

Task-5mins In twos or threes think of one positive & one negative teaching experience you may have Choose one of these experiences to summarise and present to the group What did the “teacher” do to make this effective or ineffective? 4

Why don’t we just sit you down in rows and teach you all the facts you need to know? Thoughts……

And because….. ‘Education is about lighting fires, not filling buckets’ (WB Yeats)

2 principles we use:Constructivism Construction – building on your existing knowledge, skills and experience Context – important to maximise learning, and to apply it Collaboration Working with other people Exploring different perspectives Understanding that ‘knowledge’ varies with context and with culture

2 principles we use: Adult Learning Learning what’s important to you Learning things which are useful for the real world Learner, not teacher, is responsible Learning is self directed Learning is continuous and adapts to new situations – spiral, not linear

Discuss…. What are you going to have to learn or want to learn on the rest of your GP training scheme…. Duos / trios: then Generate lists

nMRCGP competencies Communication and consultation skills Practising holistically Data gathering and interpretation Making diagnoses and decisions Clinical management Managing medical complexity Primary Care administration and IMT Working with colleagues and in teams Community orientation Maintaining performance, learning and teaching Maintaining an ethical approach to practice Fitness to practice You will already have seen… 10

Areas (Domains) of learning Can anyone suggest what this means?

Areas (Domains) of learning Knowledge cognitive domain – recall, evidence base, application of knowledge, Skills psychomotor domain (how to do things) competencies, clinical, practical, communication, problem solving. Attitudes Affective domain – interest, appreciation, adjustment, values, beliefs, ethics, personal care for patients

Miller’s Pyramid Action Does Performance Shows How Competence Knows Knowledge Shows How Knows How Performance Competence Does Action To remind you where it sits on Millers pyramid of competence, AKT sits at the bottom, knows and knows how. CSA pushing higher up WPBA because it relates to the learners’ experience in the workplace sits at the top 13

Miller’s Pyramid Knows Knowledge AKT Shows How Knows How Performance Competence CSA Does Action WPBA To remind you where it sits on Millers pyramid of competence, AKT sits at the bottom, knows and knows how. CSA pushing higher up WPBA because it relates to the learners’ experience in the workplace sits at the top 14

What do the assessments test? AKT – DOPS – MSF-- PSQ – 15

What the assessments test AKT – mostly knowledge DOPS – mostly skills MSF, PSQ – mostly attitudes, some skills and knowledge CSA exam, miniCEX, COT, CbD, CSR – test integration of all three 16

Task… In pairs: unconscious competence… grid on flipchart Half outside given task. Give instructions how to move to get up from the floor : not sit up, stand up etc Subjects only do what they are asked to do. 17

Brainstorm: What ways of teaching/learning can you think of? For knowledge For skills For attitudes

Acquiring knowledge Lectures Tutorials Books Journals Electronic information sources

Project based learning Other Methods Lecture Debate Buzz groups Mini-lecture Brainstorming Action learning Project based learning Case discussion Critical incident Role play Triadic teaching PBL Video teaching Task groups Balint group microteaching Buzz group = to combat inactivity; small group learning; “turn to a neighbour and share opinions and reactions for a short time”, then feed back Mini-lecture = a short burst of input, fact or theory, in the course of a group activity aimed at stimulating discussion or linking up points. Participants may contribute their own ideas, thus increasing involvement with the material, introducing variety, distributing effort and responsibility, and developing presentation skills. Task groups = subgroups are each allocated a topic to analyse and report back to a plenary as a contribution towards a wide picture; collaborative learning from each other Action learning = learning by doing; “watch one, do one, teach one”; good for practical skills Project based learning = another learning by doing method Case discussion = indispenable; rooted in real life and in the personal experience of the learner; real questions; real solutions; yet flexible enough to range beyond the immediate Balint = focuses mainly on the doctor and the awareness of his own feelings about an unfolding case that is presenting challenges, rather than the clinical content of the case; good for feelings and attitudes; identifying the feelings of others Role-play = very valuable technique. Works best when it arises naturally in the process of 1-1 or group teaching. Role reversal is helpful too. Triadic teaching = three participants – the subject, the listener, the observer Microteaching = analysing complex behaviour like communication skills. Dissecting it and focussing on the component parts. Usually via video work.

Teaching methods Quiz Lecture / presentation CBD Problem based small group learning (PBSGL) Mind maps Media Group tasks (buzz groups etc) Reflective and self directed learning 21

Some learning tools used in GP Problem case analysis – things you know you don’t know Random case analysis – issues you may not have identified Significant event analysis – learning from mistakes and near-misses PUNS and DENS 22

Experiential learning Who has heard of it? 23

Experiential learning Experience Test implications of concepts in new situation Observe and reflect Make abstract concepts and generalisations

Experiential learning (Kolb) concrete experience observation, reflection formation of abstract concepts and generalisations testing implications of concepts in new situations

Teaching a dog to whistle

To put it another way:

Aims & Objectives Important for any session you do Good starting point – focus RCGP Curriculum statements may help Make the session relevant to General Practice

Aims & Objectives What is an aim? What is an objective? Duos example of each…

Aims & Objectives Aims are general statements of what is to be achieved “better insight into management of COPD” Objectives are specific statements of what is to be learned at each stage. “understand the different therapies and their step line use” (GOLD)

Objective Task or Behaviour – stated with action verbs Conditions – under which task is performed Criteria – by which to judge the outcome SMART

Lesson Plans- “My session’’ Plan session! (timings, activities, resources, materials) Establish learner’s agenda Aims Objectives (?link to curriculum statement) Main body of session Record any learning needs which arise Review learning outcomes Summarise and conclude session (plenary) 4 groups> 2 groups : present 1

Learning from colleagues Sharing knowledge Sharing resources Teaching skills Offering different perspectives Facilitating reflection Giving each other feedback

Crib sheet on feedback on teaching sessions.

Task Plan a session on dementia to give to your colleagues

Dementia session: Plan!! Think… (timings, activities, resources, materials) Establish learner’s agenda Aims Objectives (?link to curriculum statement) Main body of session Record any learning needs which arise Review learning outcomes Summarise and conclude session (plenary)

What matters…. learning what’s important to you applicable in the real world (context) learner, not teacher, is responsible learning is self directed learning is continuous, must adapt to new situations

OVER TO YOU! 38