Residents are not only at the hospital to train in a demanding setting. They soon take on a teaching role that carries its own challenges. An online education module brings preceptors up to speed on a fast, focused and proven approach to be an effective teacher in a clinical setting.
The one-minute preceptor teaching model consists of five steps that cover a supervisory encounter from start to finish. While medical students or interns will be the ultimate beneficiaries, the module is designed to relay effective teaching methods to preceptors, who may feel overwhelmed trying to keep up with other residency tasks and with little time available.
The module, “Residents as Teachers,” is of the AMA GME Competency Education Program offerings, which include more than 25 courses that residents can access online, on their own schedule.
Among the program’s experts are several who contributed to the AMA’s Health Systems Science textbook, which draws insights from faculty at medical schools that are part of the Association’s Accelerating Change in Medical Education Consortium.
Modules cover five of the six topics—patient care, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice—within the ACGME’s core competency requirements. The sixth requirement, medical knowledge, is one that is typically addressed during clinical education.
Five steps to effective teaching
The 12-minute module presents and analyzes the simulated mentoring of a preceptor by an experienced physician, who sets an example when interacting with her student.
Key elements of the teaching model are:
Get a commitment. This step provides an opportunity to assess the learner's clinical reasoning. For example, the learner might be asked a simple, open-ended question like, “What do you think is going on?”
Ask questions to gather supporting evidence. This is the moment where the preceptor can garner insight into how the learner thinks, by requiring the learner to analyze and synthesize information when answering a question, such as, “What led you to that conclusion?”
Teach a general rule or concept. The objective is to impart knowledge that the learner could use in future cases involving a similar patient. The phrasing can follow a model of “when you see this, think of this.” For example, “When you see a woman with abdominal pain, think of pregnancy.”
Include positive reinforcement. The focus here is on relating what was done well and in a way, that is meaningful to the learner. The module’s example, “You did a good job collecting the history, and your presentation was well organized,” is far more useful than a generic comment such as, “That was a good presentation.”
Provide formative feedback. Positive comments have their place, but feedback that corrects mistakes or suggests alternatives is essential. The module underscores the importance of formative feedback, which “is information intended to modify the learners thinking or behavior for the purpose of improving learning.”
Feedback should be frequent, the tone informal, and “should be timely and happen as soon after the event as possible. It should also be specific to what you have witnessed.”
An example: “You need to expand your differential diagnosis,” with a suggestion to read about the clinical topic at issue. Another approach is to ask the learner to provide a self-assessment as the starting point for preceptor comments.