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Principle of Clinical Teaching. Supreeya Wongtra-ngan,MD.,MHPEd. 4 สิงหาคม 2548 เรียนท่านคณบดี - PowerPoint PPT Presentation
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Supreeya Wongtra-ngan,MD.,MHPEd
4 สิ�งหาคม 2548เรี�ยนท่�านคณบดี�
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What is Clinical Teaching?
Where does it take place?
When does it take place?
• Bedside teaching• OPD, OR, LR• Ward rounds• Independent patient contact• Simulation, Role play• Case discussion• Home visit• etc
ผ6�เรี�ยนขีองเรีาค+อใครี
Principles of learning
Learning climateInternal motivationMeaningful learningLearning objectiveIdentify resourcesPracticeReinforcement
The Learning Pyramid
Lecture
Reading
Audiovisual
Demonstration
Group discussion
Practice by doing
Teach others
5%
10%20%
30%
50%
75%
80%
National Training Laboratories, Bethel, Main,USA
AverageRetention Rate
• Be enthusiastic
• Interested in the well-being of students
• Prepare for your teaching
• Authentic medical problems
• How to improve teaching and students’
learning
Ronald J Markert, 2001
CLINICAL COMPETENCIES
Factual Knowledge
Technical Skill
Problem Solving Skill
Communication Skill
Manners & Etiquette
Recall
Comprehension
Application
Analysis
Synthesis
Evaluation
Cognitive domain
Bloom 1956
CLINICAL COMPETENCIES
Factual KnowledgeTechnical SkillProblem Solving SkillCommunication SkillManners & Etiquette
Perception
Set
Guided response
Mechanism
Complex overt response
Psychomotor domain
Simpson
Clear understanding of the task
Supervised practiceDirect experienceRepetitionPersistence
ผ6�ป็7วยน��นสิ0าค�ญไฉัน???
In what may be called the natural method of teaching the student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end.
Sir William Osler,1904
Be on timeInsist that students arrive on time
Plan the clinical teaching session
Involve the patientsInform the charge nurseInvolve all the studentsInsist on a standard format
Use a problem –solving approach
Conduct discussion away from the patientDo not try to do too much
การีเตรี�ยมพรี�อม
ป็รีะเม�นผล การีท่ดีลองฝึ?กป็ฏิ�บ�ต�
สิรี�ป็ขี�อสิ0าค�ญหล�งพบผ6�ป็7วย สิรี�ป็ขี�อสิ0าค�ญก�อนนศึ.พบผป็.
(Debriefing)(Briefing)
ช้�วงพบผ6�ป็7วย
Clinical learning cycle
Briefing Briefing patient students
Debriefing Clinical
Session practice
Including
the Patient
Briefing the patient Explaining the purpose Seeking co-operation Negotiating roles Preparing patient
Briefing students Providing a framework Generating ideas
Clinical practice Modelling appropriate
behaviors Using questions
Debriefing Analysis discoveries Discussing insights
CLINICAL COMPETENCIES
Factual KnowledgeTechnical SkillProblem Solving
SkillCommunication SkillManners & Etiquette
You are driving a car.
On one big storm night.
You are passing a station.
There are three people who are waiting for the bus
One doctor who saved your life before.
One guy/lady who is someone you have been dreaming to get married to.
One old lady who is dying.
You can only take one passenger, which one you will choose? Please explain your reason.
" Give the car key to the doctor, let the doctor take the old lady to the hospital and I stay to wait for the bus with the lady of my ream!"
Everyone I know think the above answer is the best answer, but there is no one (including myself) can think of this answer first.
Is that because we never want to give up any advantage we held in our hands (the car key)? Sometimes, we would gain more if we were able to give up our stubbornness, limitations, and advantage.
CLINICAL COMPETENCIES
Factual KnowledgeTechnical SkillProblem Solving SkillCommunication SkillManners & Etiquette
• Informed consent
• Confidentiality
• Truth telling
• Maternal-fetal conflict
• Quality end of life care
• Conflict of interest
• etc
Objective
Learning experience
Learner
Evaluation
Education cycle
• Multiple choice question• Modified essay question• Short/ Long case• Case report• Structured oral exam• Objective Structured Clinical Examination (OSCE)• OSLER• Direct observation: check list, rating scale• Standardized patient
To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all
Osler 1903
Good night