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A Faculty Development Exercise in Clinical Teaching. Eugene C. Corbett, Jr., MD Subha Ramani, MMEd Elizabeth G. Armstrong, EdD . Clinical Teaching. Teaching that enables a learner’s clinical performance development, in the care of the patient. experiencing.

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A faculty development exercise in clinical teaching
A Faculty Development Exercise in Clinical Teaching

Eugene C. Corbett, Jr., MD

Subha Ramani, MMEd

Elizabeth G. Armstrong, EdD

Clinical teaching
Clinical Teaching

Teaching that enables a learner’s

clinical performance development,

in the care of the patient


1Identify problems from real life experience

Just Do It!

8Present a goal and discuss next steps

Activate Prior Knowledge

7Make clear the relevance for practice and encourage commitment to change

2Understand the problems and differences,brainstorm




6Select a solutionGive opportunity for personal practical application, e.g. simulators

3Select a specific problem, present data

What New


Try It Out

5Evaluate consequences of solutions

4Consider alternative solutions




What next?



How does it work?



Today s clinical teaching exercise
Today’s Clinical Teaching Exercise:

Create a clinical teaching scenario

Try it out

Reflect upon it

Vignette Creation, Practice & Feedback


Design a clinical teaching scenario role play

Within individual group X or Y

20 minutes


2 Teaching, Observation and Debriefs

(20 minutes each)

Combined X + Y Group

40 minutes


Large Group Discussion

Reflections on clinical teaching, faculty development methods, and implications for teacher beliefs and practice

20 minutes

X and y groups
X and Y Groups

  • X Groups: Communication skills teaching

    As the clinical teacher, you are about to visit with a patient in the outpatient setting who has come in to discuss their care pertaining to a new diagnosis of cancer. You are working with a third year clerkship student and a pgy2 resident.

  • Y Groups: Physical examination skills teaching

    As the clinical teacher, you are about to visit at the bedside with a patient admitted for congestive heart failure. This creates the opportunity to work with your clerkship student, an intern and a pgy3 resident on their physical examination of a patient with mitral valve disease.

Clinical care performance competencies
Clinical Care Performance Competencies

Professionalism (many dimensions)

Patient engagement & communication skill

Scientific knowledge and method

Clinical history-taking

Mental & physical examination

Clinical testing & imaging (select, justify, interpret)

Basic clinical procedures

Information management (present, record, search, critique)

Diagnosis (differential diagnosis, patient problem lists)

Intervention (prevention, treat, palliate)

Prognosis (anticipate and plan for the future)

Placing care in practical context (personal, family, ethnic, economic, health system…)

Recommendations for Clinical Skills Curricula, AAMC, 2005, 2008

Clinical teaching requirements
Clinical Teaching Requirements:

Clinical expertise

Learner levels & needs

The Patient

Clinical circumstances (setting, time)

Clinical focus

Curriculum perspective

Learner evaluation & feedback

Experiential learning theory

Teacher self-efficacy


Just Do It!

Discuss scenario Identify problems

Activate Prior Knowledge

Do role-play Debrief Discuss next steps




Evaluate consequences

Get ready for role-play

Consider solutions



Try It Out


Think establish goals

  • SMART goals

    • Specific, measurable, attainable, realistic, timely

  • Ends goals

    • Impact on patients

    • Impact on learners: Improved clinical skills, professionalism…..

  • Means goals

    • Impact on teachers:

      • Knowledge, skills or attitude

      • Immediate or long term

THINK: Establish goals

Educational frameworks

Educational Frameworks

Pair approach to peer coaching

  • P target goalsartner

    • Commit to learner’s outcomes.

    • Maintain mutual trust, respect and “safety” (try new things, make mistakes).

  • Enquire

    • Ask questions

    • Challenge learner to:

      • Look at the situation differently- self, context, assumptions.

      • Clarify what he / she wants- desired outcomes.

  • Evaluate

    • Were outcomes achieved

  • Reflect (Mirror for the learner / partner)

    • Encourage self-reflection

    • Provide feedback.

    • Identify strategy to get there (Action plan)

PAIR: approach to Peer coaching

Share debriefing and feedback

  • Start with target goalsself- reflection

  • Focus on behaviors

    • Effectiveness in achieving desired goals

    • Responses they elicited in learners

  • Identify MOST effective behaviors first

    • Why or how these behaviors were effective

SHARE: Debriefing and feedback

Share debriefing and feedback1

  • Identify target goalsLESS effective teaching behaviors

    • Why or how these behaviors were not effective

    • Shared problem solving; brainstorm alternative strategies to use

  • Plan concrete actions for future similar teaching activities

    • Reassess adequacy of goals, establish new goals

    • Use of different teaching strategies/ behaviors

SHARE: Debriefing and feedback

What do the Observers Track? target goals



“Who’s Talking?”

“Can they Analyze? Can they Present?”

The Group



“Are they Getting it?”

“Who’s Driving the Learning?”


  • Lyman, F. (1981). "The responsive classroom discussion." In Anderson, A. S. (Ed.), Mainstreaming Digest. College Park, MD: University of Maryland College of Education.

  • Flynn et al. Peer coaching in clinical teaching. Fam Med 1994;26:569-570.

  • Orlander et al. Co-teaching as a faculty development strategy. Medical Education 2000;34:257-265

  • Siddiqui et al. 12 tips to peer observation of teaching. Medical Teacher 2007; 29: 297–300