1. “One Minute Preceptor” Model (OMP)
Dr. Jatin G. Bhatt
Professor & head
Dept. of surgery
Pdumc, rajkot
Preceptor= Teaching at College/University
“One Minute Preceptor” Model Dr. Jatin Bhatt

2. “Education’s purpose is to replace an empty mind with an open …….”
Good Afternoon
“Education’s purpose is
to replace an empty mind with an open …….”
-Malcolm Forbes
“One Minute Preceptor” Model Dr. Jatin Bhatt

3. Short Role Play Current Scenario in OPD, Office, Wards, Labs, etc…….
Surgical Resident informs consultant regarding pt seen in OPD
“One Minute Preceptor” Model Dr. Jatin Bhatt

4. Challenges and problems in clinical teaching?
Student
Teacher
Patient
Infrastructure/Management
“One Minute Preceptor” Model Dr. Jatin Bhatt

5. Challenges and problems in clinical teaching?
Time pressures
 Competing demands
 Clinical Patient
Care Vs Teaching
 Administrative
 Research
 Often opportunistic makes planning more difficult
 Increasing numbers of students
“One Minute Preceptor” Model Dr. Jatin Bhatt

6. Challenges and problems in clinical teaching?
Fewer patients
shorter hospital stays
patients too ill or frail
more patients refusing consent
Often under resourced
Clinical environment not “teaching friendly”
Rewards and recognition for teachers poor
“One Minute Preceptor” Model Dr. Jatin Bhatt

7. Challenges and problems in clinical teaching?
Lack of clear objectives and expectations
Focus on recall not problem solving skills, attitudes
Passive observation, no active participation
Teaching pitched at wrong level
“One Minute Preceptor” Model Dr. Jatin Bhatt

8. Challenges and problems in clinical teaching?
Inadequate supervision and provision of feedback
Little opportunity for reflection and discussion
Teaching by humiliation (embarrassment)
Informed consent not sought from patients
Lack of respect for privacy and dignity of patients
Lack of congruence/continuity with rest of
??????????
“One Minute Preceptor” Model Dr. Jatin Bhatt

9. books and pt
“To study the phenomenon of disease without books is to sail an uncharted sea,
while to study books without patients
is not to go to sea at all”
Sir William Osler , Prof. of Medicine, Oxford, England.
“One Minute Preceptor” Model Dr. Jatin Bhatt

10. OMP Model Neher and colleagues (1992) Five Step Micro skills
Get a commitment
Probe Supporting evidence
Teach General Rules
Reinforce what was done right
Correct mistakes
Ambulatory teaching encounters
Any Setting: Office, OPD, A&E, Wards, Indoor, Rounds, OT, Laboratory
“One Minute Preceptor” Model Dr. Jatin Bhatt

11. OMP: Five Micro skills 1. Get a commitment
2. Probe for supporting evidence
3. Teach general rules
4. Reinforce what was done right
5. Correct errors
With time constraint
Feedback
Encouragement
“One Minute Preceptor” Model Dr. Jatin Bhatt

12. Role Play
A resident in Surgery presents a case to consultant while he is consulting in outpatient clinic OMP: Ambulatory Teaching Encounters
“One Minute Preceptor” Model Dr. Jatin Bhatt

13. 1. Get a commitment “What do you think is going on?”
Diagnosis
"What other information do you feel is needed?“
Investigations
"What would you like to accomplish in this visit?“ Fu
"Why do you think this patient has been noncompliant?“
????
Open ended questions
“One Minute Preceptor” Model Dr. Jatin Bhatt

14. 2. Probe for supporting evidence
"Why do you think this?“
Prove Diagnosis….
"What were the major findings that led to your conclusion?"
"What else did you consider? What kept you from that choice?“
D/D
"What questions are arising in your mind?“
How will you Mx? Any Doubts!!!!!!!!
Direct Questions: Knowledge & Clinical Reasoning
“One Minute Preceptor” Model Dr. Jatin Bhatt

15. 3. Teach general rules Investigations for 20
D/D: Antibioma, Traumatic fat Necrosis
H/o Rapid increase in Size in short time
Example:
"If the patient only has cellulitis, incision and
drainage is not possible. You have to wait until
the area becomes fluctuant to drain it."
“One Minute Preceptor” Model Dr. Jatin Bhatt

16. 4. Reinforce what was done right
Correct Diagnosis, FNAC, Surgery
Example:
“Obviously you considered the patient’s finances in your selection of a drug. Your sensitivity to this will certainly contribute to improving his compliance. Well done.“
Encourage
“One Minute Preceptor” Model Dr. Jatin Bhatt

17. 5. Correct errors Feedback
Stage: IIIA & IIIB
Explain: Prognosis and Surgery
Example:
"You may be right that this child’s symptoms are probably due to a viral upper respiratory infection. But you can’t be sure it isn’t otitis media unless you’ve properly examined the ears.“
Feedback
“One Minute Preceptor” Model Dr. Jatin Bhatt

18. Summary
First two micro-skills diagnose learner knowledge and reasoning
Get a commitment
Probe Supporting evidence
Last three micro-skills offer tailored instruction
Teach General Rules
Reinforce what was done right
Correct mistakes
Let Learner Speak
For Teacher be specific
“One Minute Preceptor” Model Dr. Jatin Bhatt

19. OMP: Reference First three Micro skills: 40-60% encounters
4th (Reinforce done right) & 5th (Correct mistakes) in 12.8% and 18.6% encounters
William Huang, Dept. of Family and Comm. Medicine, March, 2006.
“One Minute Preceptor” Model Dr. Jatin Bhatt

20. OMP: References
Neher JO, Gordon KA, Meyer B, Stevens N. A five step “microskills” model of clinical teaching. JABFP, 5:41924, 1992.
Aagaard and colleagues (2004) show in a study that five-step micro-skills encounters more effective than the traditional precepting encounters.
“One Minute Preceptor” Model Dr. Jatin Bhatt

21. Limitations
If OMP used as a only teaching technique because of its simplicity may reduce richness of clinical teaching.
Learners psychological reaction to encounter
Poor data
“One Minute Preceptor” Model Dr. Jatin Bhatt

22. Conclusion Simple & Practical Easy to use: OPD, A & E, Indoor, Rounds
Well accepted
Efficient & effective
Dose not prolong teaching process
Preceptor feel more confident in pt diagnosis & learners evaluation
Feedback more specific
Motivate learner
Learning Outside reading
“One Minute Preceptor” Model Dr. Jatin Bhatt

23. Summary
Distinguished clinical teachers listen to case presentations during teaching rounds, they first diagnose patient’s problem, then assess learner’s needs, and finally provide targeted instruction to learner’s point of need
“One Minute Preceptor” Model Dr. Jatin Bhatt

24. Life Vs Education
“One Minute Preceptor” Model Dr. Jatin Bhatt

25. Thanks
“One Minute Preceptor” Model Dr. Jatin Bhatt