Communicate beforehand to establish expectations - Orienting = Investing See the One Minute Learner pocket card -Included below When to arrive, which patients to see, what to focus on as part of the history or physical examination, not every patient needs a complete history and physical, when to ask questions, etc. Save time in clinic Plan which patients your learner should see “Just get the history and we can examine the patient together” unless it’s a very focused exam. Examining in tandem saves time and you can observe the learner’s technique Learner can see every other patient since they may take additional time for their history and physical. You can complete 1 patient visit then join the learner for the second patient Assign the learner a “quick patient” or one that needs extra attention depending on the flow of your day Have the learner working with an interpreter if the patient needs one and then can present to you Students train to do motivational interviewing, you can ask them to help a patient with their weight or smoking cessation etc. Tell the learner what they should be presenting and how since you may already know the patient or have their med list in front of you. “So what is new since I saw this patient 2 weeks ago” Do you need a full history of present illness and summary statement? Skip to the problem(s) and make initial recommendations? Learner Presenting in the Presence of the Patient PIPP, saves time, patient gets and perceives more time spent with their provider Save time charting Medical students and PA students can write chart notes Choose what you want the learner to document A more complex history but not necessarily the entire note or assessment plan Review of the medications The physical examination Patient education Students can help your knowledge base by doing a learning issue Your student can look up information on a new medication you’re not familiar with yet Your student can check to see if there are updated guidelines “So you recently did X rotation, what are they doing there that might help us here?” Giving feedback can save you time and raise your status as a teacher Give it timely so the student can improve their care and efficiency Given in the moment you won’t have to try and remember it later.Label it as feedback so the student knows they are getting feedback Save time teaching Teach to the patient for the learner’s benefit Teach to the learner for the patient’s benefit Nonthreatening way of educating patients or learners and avoids repeating the information Bill appropriately for your time Time-based billing, you can be in the room reviewing the chart, listening, documenting while the learner is taking a history or educating the patient or examining the patient for learning instead of your focused exam for patient care at hand.
Other tips? Please contact Daniel Stulberg Dstulberg@salud.unm.edu with your suggestions.
Tips for Working with Learners in Clinic
UNM School of Medicine CPL Resources CPL - the Office for Continuous Professional Learning (formerly OMED) under the leadership of Gary A. Smith PhD has many educational offerings. Teachable Moments in the Clinic or Hospitals a just-in-time resource that you can link on your smart phone for quick reference while teaching. Easy to review sections with downloadable reminder cards on… 1 Minute Preceptor SNAPPS Modeling Priming and Framing Focused Half–Day Activated Demonstration CPL provides an online module/workshop - Teaching with Limited Time While Providing Patient Care in the Outpatient Setting for which Dave Stromberg, Patrick Rendon, and Deepti Rao provided expert consultation. There is a Toolbox for Effective Clinical Teaching Workshop facilitated by Kristel Montaño, MD, Patrick Rendon, MD, and David Stromberg, MD. Faculty can use tuition remission for both of these offerings, which are free to volunteer faculty.
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ONE MINUTE LEARNER FOR THE STUDENT: One Minute Learner Huddle Have this brief discussion with your preceptor before the session starts Prepare by thinking about your learning goals before your huddle with your preceptor Preview the schedule and charts “Can I touch base with you quickly about the plan for this clinical session?” 1. GOALS: Remember to be specific! (1) Preceptor’s and (2) Learner’s (3) Think about your current level/stage “Are there specific patients/diagnoses/skills I should focus on?” “I have been in clinic for 3 weeks, so I am very comfortable with the patient population.I need to work on giving the full plan and patient education directly to the patient.” 2. GETTING GOING: When, how and who should I see? “Should I room patients myself?” “Should I see any patient that is available?” “Should I see (or not see) specific patients?” 3. HOW MUCH and HOW LONG “How much of the visit should I do on my own?” “How long should I spend with the patient?” 4. PRESENTING: Where and how? “Where should I present to you?” “What presentation format should I use?” “How detailed a presentation do you want?” 5. CHARTING: When and how? “What format should I use for my notes?” “When should I write them?” 6. QUESTIONS: “When is a good time to ask questions that come up?"
Department of FamilyMedicine, Boston University School of Medicine 2014
ONE MINUTE LEARNER FOR THE PRECEPTOR: One Minute Learner Huddle Have this brief discussion with your student before the session starts Have the student prepare for this conversation You and the student can preview the schedule and charts 1. GOALS: Remember to be specific! (1) Student’s current level of training/experience (2) Student’s specific goals Encourage student’s self assessment (3) Your goals for the student Use your observation of their performance 2. GETTING GOING: When, how and who should the student see? Should the student see any patient that is available? See (or not see) specific patients? Should the student room patients themselves?Talk with your MA or nurse? 3. HOW MUCH and HOW LONG How much of the visit should the student do on his/her own? How long should the student spend with each patient? 4. PRESENTING:Where and how? Where should the student present to you? What presentation format should be used? How detailed a presentation do you want? 5. CHARTING:When and how? What format should the student use for notes? When should the student write notes? 6. QUESTIONS: When is a good time to discuss questions the student has?
Department of Family Medicine, Boston University School of Medicine 2014