Erc Manchester Medical Education 2010

Clinical debriefingClinical debriefingKurt WilsonKurt Wilson

Intended learning outcomes

Use clinical debriefing to deliver teaching, learning and assessment

Enhance reflective practice

Gain greater two-way feedback through clinical debriefing

Intended learning outcomes

Who helps them understand what is happening in clinical environments?

How well are they able to help each other understand wider issues from clinical experience?

‘Miseducation’

Do students learn as intended in community?

The GP - Good

The GP – Not so good

The GP - Good

The GP – Not so good

The GP - Good

The GP – Not so good

Where does it happen at the moment?

What is meant by “clinical debriefing”

Case presentation

History Examination Investigations

Margin hypothesis Best test?Examination first

Debate and discussion

Tutor led Student led

What might students get out of it?

… very useful to learnfrom fellow students…

…very good as interactive and varied…

…topic discussion was particularly

useful as the group were able to address learning objectives not raised

in PBL

…feedback was constructiveand very encouraging… …I felt like I was applying my

knowledge & this simulates what will happen later in ‘real life’

Session overviewSession overviewGroups of 8 studentsGroups of 8 students

2.5 hours long2.5 hours long

Case presentations Case presentations

DiscussionDiscussion

Self directed learning, reflection and teamworkSelf directed learning, reflection and teamwork

Use of generic techniques and structured sessionsUse of generic techniques and structured sessions

How to develop clinical thinking How to develop clinical thinking skills?skills?

Improving history taking/presentation/group interaction Improving history taking/presentation/group interaction and case discussionand case discussion– Ideas, concerns, expectationsIdeas, concerns, expectations– Margin hypothesis generationMargin hypothesis generation– Examination findings firstExamination findings first– Best test?Best test?

– Sensitivity and specificitySensitivity and specificity

Role play

Case presentation

Use some skills to enhance active learning

Case one

Case presentation

History Examination Investigations

Margin hypothesis Best test?Examination first

Margin hypothesis generation

Differential diagnosis Generation

Ranking

Discussion

Case Two

Case presentation

History Examination Investigations

Margin hypothesis Best test?Examination first

Best test?

Only allowed one testWhich one and why?

Specificity (false positives?)

Sensitivity (false negatives?)

Positive and negative predictive values

Topics for discussion

Issues surrounding patient centred care

Treating individuals versus population medicine

Disclosure, recommendation and understanding

Why clinical debrief is useful?

Stimulate deeper and more complete learning?

Address ‘mis-educative processes’?

Different perspectives?

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