Teaching Skills:

• One Minute Preceptor
• Feedback and Evaluation
• RIME Evaluation Framework
• Planning Guide for Teaching Skill Lessons
• Teaching Curriculum Development
• Lecture Skills

Teaching Skills (External Resources):

• Preceptor Development Program e-Learning Tools
• The Expert Preceptor Interactive Curriculum
• General Internal Medicine Faculty Development Project
• Medical College of Wisconsin Faculty Development Programs

One Minute Preceptor

• Get a commitment. (What do you think is going on?)
• Probe for supporting evidence. (Why do you think this?)
• Teach general principles.
• Reinforce what was done correctly and the effect it had.
• Correct mistakes. Explain what they did correctly, incorrectly, and how to improve for the next time.

Additional Techniques

• Ask reflection questions:
  • What did you learn from seeing patients today?
  • What troubled, surprised, moved, or inspired you today?
• One Zebra using MINTS (Metabolic, Infections/Inflammatory, Neoplastic/Neurological, Toxic/Traumatic, Systemic)

Performance appraisal are judgmental evaluation.  Feedback offers insight into what the person actually did as well as the consequences of his/her actions. Highlighting the dissonance between the intended results and the actual results, providing impetus for change.

How to give feedback effectively

• Differentiate feedback from praise / positive reinforcement or counseling / career guidance with encouragement and empathy.
• Time feedback appropriately -- immediately after critical incident or after short interval (emotions leveled, data gathering, or formal time scheduled)
• Give descriptive rather than evaluative comments (focus on the problem not the individual, e.g.: "We are having a problem with patients being checked in late" vs. "You take too long to check patients in."
• Clarify understanding the problem
• Specific data/concrete examples
• Ask for rephrasing of the concerns to verify understanding
• Encourage participation and creativity in identifying possible solutions. (In search of excellence)
• After the feedback session, write down short summary -- what was accomplished, what issues were discussed, and whether future goals were established.

How to Gather Feedback Information

• Specify areas and criteria for evaluation
• Base the evaluation on direct and specific information
• Consider alternative sources of information
• Separate performance evaluation from assessment of potential pitfalls:
  • Threat of control (suppress communications better to focus on problems not person)
  • Neutrality and empathy (listen and follow up on suggestion, e.g.: before and after points to make (plan/notes) (comments on outcome)
• Define the purpose of the session
• Ask questions to encourage a 2 way exchange
• Identify specific problem areas
• List possible solutions (including fm/appraisee)

Reporter

• Accurately gather and communicate clinical facts
• Requires basic skill and knowledge of what to look for
• Recognizes normal versus abnormal
• Confidence to identify and label new problems
• Consistency in "bedside" skills, sense of responsibility
• These skills must be mastered to pass

Interpreter

• Prioritize among problems identified in patients
• Offers differential diagnosis (at least three)
• Follow-up of tests and their interpretations
• Selecting clinical findings which support possible Dxs and applying test results to specific patients
• Transitions from "bystander" to active participant in patient care

Manager

• Deciding when action needs to be taken
• Propose and select among at least three diagnostic and therapeutic options for the patient
• Take into account particular patient's circumstances and preferences
• Requires more confidence, knowledge, and judgment

Educator

• Mastery of the basics
• Self-directed learning
• Reads deeply and shares new learning with others
• Defining important questions to research
• Takes drive, insight, skill, maturity, and confidence

Skill analysis

• Do you have a written checklist that describes in adequate detail the steps required for performing the procedure?
• Is the list clear? Does it mirror the correct order of activities when steps are sequential? Does it denote areas in which students are likely to encounter difficulties?
• Are discussion opportunities provided to be sure students understand each step and its importance?

The model of performance

• How will you provide a model of performance which demonstrates accurate execution of the required skill?
• Does the model of performance show all necessary details? Is it designed so students can comprehend the steps in the procedure?
• Will there be adequate opportunities for students to observe the model?
• How will students be able to review portions of the model later in the lesson?
• Will students be able to use the checklist of steps against the model of effective performance to observe how each specific step is carried out?

Practice

• How will students practice the required skill?
• Is practice organized so that students can learn the skill gradually? Are there opportunities for simulated practice on models and peers prior to patient contact?
• Are practice sessions conducted in groups small enough for all students to be actively engaged in learning?

Supervision and evaluation

• In what ways will students assess their own performance?
• What opportunities will students have to receive feedback on their performance?
• Is final competence assessed by having each student perform the complete procedure without assistance?
• Will additional supervised practice be available for students having difficulties?
• What activities will be designed (tests, discussions) to test knowledge not measure by performing the skill?

Space and materials

• What are the space requirements for the lesson?
• What equipment will be necessary?
• Is practice planned to ensure the best use of available space and equipment?

Planning:

• Identify/state goals and objectives
• Select subject content
• Sequence subject content
• Allocate instructional time
• Identify resources and constraints
• Select instructional methods and materials
• Develop evaluation plan
• Assess student characteristics

Development:

• Arrange course schedule
• Sequence learning experiences
• Prepare instructional materials
• Prepare lectures, labs, etc.

Management:

• Lecture
• Lead seminars/discussions
• Conduct laboratory experiences
• Conduct clinical experiences
• Arrange for personalized instruction
• Refine teaching skills

Evaluation:

• Assess student learning
• Assess teaching-learning process

Organizing

• Specifies purposes of the lecture in introductions
• Sets ground rules for audience participation
• Relates the main body of information to the introductory purposes
• Makes clear transitions between different segments of the lecture
• Uses clear, relevant examples to illustrate main ideas
• Clarifies technical terminology
• Periodically summarizes most important points or ideas of the lecture
• Develops a conclusion related to the purposes and body of the lecture
• Cites appropriate authorities to support statements
• Presents divergent viewpoints for contrast and comparison
• Separates facts from opinions

Delivery and Audio Visual Aids

• Speaks at suitable volume
• Speaks at suitable pace
• Varies rate, pitch, force of voice for emphasis
• Speaks in a conversational manner
• Uses eye contact (scans total audience)
• Uses a variety of facial expressions
• Uses hands and arms appropriately
• Moves purposefully
• Coordinates A-V aids to enhance understanding of the subject matter
• Uses A-V aids which are easily visible or audible

Lecture Skills

• Insert pauses/ask questions
• Written copy? Tell them you'll pass it out later
• 20 minute rule