1. AoTrauma Regional Hand Course Running a practical exercie A N Moharram MD, FRCSEd Precourse meeting Professor of Orthopedic Surgeon, Cairo University Egypt Dubai UAE October 10, 2011

2. What is a practical exercise? « I hear and I forget. I see and I remember. I do and I underestand» Confucius (551 BC- 497 BC)

3. What is a practical ? Structured and interactive learning Demonstration of new skill Explanation of the steps Talking through procedure Practicing new skill Reflection on performance Feedback & support

4. Who is Practical Director? Planning of the session Preparing effective and stimulating session Following the A,B,C of learning Focusing on learning outcomes Communication with participants

5. What does table instructor do? Works with the director One-on-one instruction and support Delivers constructive support Works within assigned group Observe and interact with all group members

6. How people learn? AffectivePsychomotor Cognitive

7. Key points Skill is not reflex action Complex movements require practice Reinforced practice Environmental factors Feedback

8. Before the session Sufficient numbers of artificial bones, Instruments, and implants Review all the video/DVD Preview the video(table instructors) Flip chart (key steps) Has enough time been allocated Time for supervised practice Time for feedback Time for evaluation

9. Structuring the practical Set Dialogue Closure

10. Set Room temperature, light, and quietness Does all the equipment work? Do you know how to use them? Welcome the participants Keep the introduction brief and to the point

11. Dialogue Keep in mind that adult learners need to know the application of what you want them to learn or to do

12. Dialogue Divide the content into short manageable section Do you have the attention of the all learners Consider the safety issues Apply the four-step approach

13. Closure Reflect on outcomes and key learning points Address questions Summarize main points Deliver a final “take-home” message

14. Four-step approach 1- Silent demonstration 2- Demonstration with explanation 3-Learner talks through the task (faculty performs the task) 4- Learner perform the task (50% time of the session) Video CCTV Practical director Table instructor

15. Closure Show the finished result Summarize the key points Invite questions Strong positive “take home message”

16. Role of the table instructor Reinforcement of the correct procedure and give constructive feedback Explain the steps Discuss the principles involved before the hand-on practice

17. Faculty Pitfalls Lecturing at the work station Faculty doing the skill Disinterested faculty “ I-don’t-use-this-implant” attitude Unfamiliarity with equipment & instruments Telling learners that you have better way of performing the skill

18. Student Pitfalls Talking through the demonstration Taking pictures or video instead of doing the exercise Experimenting with unsolicited or untaught techniques A general lack of interest Not interacting with other participants Inappropriate level of participation: Monopolizing Rushing ahead Too complacent

19. Some advices Dealing with some personalities Beware alternate agendas Direct disruptive or monopolizing learners Silence the chatterboxes Engage the silent learners

20. “Excellence is an art won by training and habituation” Aristole (384 BC-322BC)

21. Table Instructor Checklist Internalize the four-step approach Familiarize yourself with exercise procedure Get to know the learners at your table Reinforce the demonstration before hands-on Stick to the script – don’t show off Be aware of time Deliver constructive feedback Provide positive reinforcement and lots of praise