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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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