Teaching Styles and Precepting Charles E. Henley, D.O. Department of Family Medicine University of Oklahoma, Tulsa

Is This Your Educational Philosophy?

Objectives Examine barriers to effective clinical teaching Define characteristics of good preceptors Review four teaching styles and uses Discuss 5 microskills of the “One Minute Preceptor”

Where Does Learning Occur? LecturesLabs Small Group BedsideClinicHallway

Clinic Attending Barriers to effective clinical teaching: Patient Features Time Factors Teaching Points

Resident Perceptions of a Good Clinic Attending Helpful Available - open door, not seeing pts., no long wait for attending Residents not treated like students Enthusiastic in teaching Cognizant of time

Teaching Based On Learners Needs Reduced Knowledge Dispersed Knowledge Tunnel Vision

Four Teaching Styles Expert Consultant SocraticCollaborativeCounseling

Traditional teacher-oriented format Attending conveys expert knowledge Response to a specific question Learner expects a direct response

Socratic Teacher uses thoughtful questioning to explore learner’s knowledge Has a predetermined goal (leads the learner to the right conclusion) Time intensive Regarded as the preferred style

Collaborative Solution to problem is not known No predetermined goal Teacher and Learner mutually explore for an answer as a team

Counseling Exploration of the intrapersonal and interpersonal issues involved in a patient encounter Balint groups

One Minute Preceptor - Five Microskills 1. Get a commitment - what is going on? 2. Probe for supporting evidence - why do you say that? 3. Teach general rules - if this happens, do this Reinforce what was right - strong work! 5. Correct mistakes - next time, try this... Gordon K, Meyer B, Irby DM. The One Minute Preceptor, JFP 1992

Get A Commitment Learner commits to a diagnosis or plan Forces learner to process information from patient encounter be supportive Resist the urge to “take over” the case

Probe for Supporting Evidence Ask for evidence that supports their opinion Be careful to not “grill” the learner Ask for alternative conclusions Reveal the learner’s thought process, and knowledge gaps

Teach General Rules Learners remember general rules better Rules that generalize to other situations Adds information to knowledge base * Avoid anecdotes or idiosyncratic preferences

Reinforce What Was Done Right Helps to firmly establish appropriate competencies Helps build self-esteem Focus on specific behaviors that can be consciously repeated Do not give general praise

Correct Mistakes Correct Mistakes Appropriate time and place Allow learner to self - critique Discuss what was wrong, then how to avoid or correct mistake in the future Be specific! Judgmental statements = inappropriate

The Teachable Moment Can happen at any time Prime teachable moment for learners Focuses the learner to the issues at hand

Summary - Facilitative Behaviors Set clear objectives / expectations Leave your ego at the door Match teaching style with needs and level of learner Develop a non-threatening environment Encourage questions Be aware of body language

Facilitative Behaviors Summarize as you go Don’t interrupt the learner- make notes Make eye contact Protect the interaction time Ask for feedback at the end Self - evaluation : “why don’t students ask me questions?”

The End