1. Teaching Medical Students Consulting Skills
Doris Young
Professor of General Practice
University of Melbourne

5. Teaching students In The GP clinic
Today we are going have an overall look at general practice in Australia. There is always some news in the papers about oversupply of doctors especially in urban Australia.
You would be aware of the AUSTUDY and HECS changes. More important to you are the issue of limited provider numbers.
How many of you are involved in the campaign against the limiting of provider numbers?
In first year you would have visited a GP for half a day. Who has been on a 3rd year elective with a rural GP? Who is a member of OUTLOOK?
You will have some preconceptions of what a GP is and what he/she does.
How many of you have a family GP?
How many of you have been to see your family GP in the last 3 months?
How many of you have been to see a GP in the last 3 months?
What do you understand by having a family GP?
I will show you a video of what some consumers think about GPs and general practice. 1

6. The beginning of education lies in imitation, wherefore pick someone worth imitating.
Martin H. Fischer, MD 1940
Here I am not so much striving to teach, as I am encouraging you to learn.
Peter Mere Latham, MD 1850

7. To teach is to touch a life forever. John Chamberlin, MD, FAAP, FACP

8. It’s all in a day’s work! A GP’s diary
cuts, bruises, colds, check ups,
births, deaths, contraception, hayfever,
nerves, bedwetting, drug abuse, loneliness, sore throats, tiredness, immunisations, repeat
prescriptions etc etc………..

9. Common comments from GP teachers
‘we have to make a living,we are running a business’…
‘having students slow me down’
‘I don’t know what to teach’
‘Patients don’t like to see a student…. Sitting in’…

10. You don’t need to ‘teach’ Help them to learn All Students CAN do more
All Students WILL do more

11. Effective clinical teacher
Communicating expectations
Stimulating interest enthusiastically
Interacting skillfully with patients
Involve the learner in the teaching process
Role modelling the desired behaviours

12. Framing the Visit Time limit How much to do (Hx and PE or just Hx)
Goal for presentation
I want a 3 minute presentation vs. I want a 1 minute consult presentation

13. Helping learners focus
Ask the learner before they go in the room what they will focus on
Ask them a question to get them thinking about a unifying diagnosis
If you let them “get it”
They’ll learn- “aha” moments are priceless
You’ll learn about their thought process
They will see you as a true teacher and role model

14. One Minute Preceptor Get a commitment
What do you think is going on? What do you want to do?
Probe for supporting evidence
What led you to that conclusion? What else did you consider?
Teach general rules
Tell them what they did right and the effect it had
Correct mistakes
Next time consider trying...

15. Efficiency strategies used by GP teachers
Have the student write the note, provide health education
Summarize the patient’s history for the student
Have the student present in front of the patient
Tell the student how far to go with the PE
Give the student specific feedback
Set limited goals for the student prior to seeing the patient

16. Priming the Learner: Uncomplicated Patients
Uncomplicated patient for “routine visit”
What screening or preventive issues are important?
Common problem like “fatigue”:
Let’s generate some differential diagnoses
What symptoms and signs should we look for?
What tests might help us?
Here is a short resource.

17. Priming the Learner: Complicated Patients
Complicated patient with urgent issue
Differential in setting of chronic issues
How will we decide if this patient needs to be hospitalized for this problem?
Complicated patient with multiple issues
Please focus just on diabetes management. What complications/problems should we worry about?

18. Make learning relevant and fun
Should always be learner-centered
Literature “review”
Reflection on what went well/wrong
Teach me something
record review
Goal of the day

19. Do’s and Don’ts Do involve them Do encourage them Do keep them busy
Do challenge them
Do make their placement a positive experience

20. Don’ts Don’t make them a wall flower Don’t bore them
Don’t humiliate them
Don’t complain to them about family practice
Don’t expect them all to love family practice

21. ackowledgement Teaching in your office:
a guide to instructing medical students and residents
Alguire, Dewitt,Pinsky, Ferenchick 2001

22. Thank you
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