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Supreeya Wongtra-ngan,MD.,MHPEd

Principle of Clinical Teaching. Supreeya Wongtra-ngan,MD.,MHPEd. เรียน คณบดี

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Supreeya Wongtra-ngan,MD.,MHPEd

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  1. Principle of Clinical Teaching Supreeya Wongtra-ngan,MD.,MHPEd

  2. เรียน คณบดี ผมเขียนบันทึกนี้ด้วยความเป็นห่วงคุณภาพของนักศึกษาปีที่ ๖ในปัจจุบัน ซึ่งผมเพิ่งสอบไปเมื่อเร็วๆนี้ เขาสามารถตอบคำถามเกี่ยวกับโรคและการวินิจฉัยแยกโรคต่างๆได้ แต่ไม่สามารถรวบรวมข้อมูลจากผู้ป่วย การซักประวัติและการตรวจร่างกายก็ทำได้แย่ อาการและอาการแสดงหลายอย่างถูกข้ามไป ทั้งการสืบค้นทางห้องปฏิบัติการ แสดงให้เห็นว่าเขาไม่สามารถนำความรู้ทางทฤษฎีมาประยุกต์ใช้ในการแก้ปัญหาผู้ป่วย ผมแน่ใจว่าเกิดจากการที่มีเวลาน้อยในชั้นคลินิก จึงขอให้คณะฯขยายเวลาเรียนออกไปอีกหนึ่งปีเพื่อเพิ่มพูนทักษะทางคลินิกมากขึ้น ขอแสดงความนับถืออย่างยิ่ง นพ.เพิ่มพูน เต็มล้น

  3. What is Clinical Teaching? Where does it take place? When does it take place?

  4. Instruction methods • Bedside teaching • OPD, OR, LR • Ward rounds • Independent patient contact • Simulation, Role play • Case discussion • Home visit • etc

  5. ผู้เรียนของเราคือใคร

  6. Principles of learning • Learning climate • Internal motivation • Meaningful learning • Learning objective • Identify resources • Practice • Reinforcement

  7. Principles of good teaching • Be enthusiatic • 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

  8. CLINICAL COMPETENCIES • FACTUAL KNOWLEDGE • TECHNICAL SKILL • PROBLEM SOLVING SKILL • COMMUNICATION SKILL • MANNERS & ETIQUETTE

  9. Taxonomy Cognitive domain Evaluation Synthesis Analysis Application Comprehension Recall Bloom 1956

  10. CLINICAL COMPETENCIES • FACTUAL KNOWLEDGE • TECHNICAL SKILL • PROBLEM SOLVING SKILL • COMMUNICATION SKILL • MANNERS & ETIQUETTE

  11. Taxonomy Psychomotor domain Complex overt response Mechanism Guided response Set Perception Simpson

  12. ผู้ป่วยนั้นสำคัญไฉน???

  13. Teaching the physical examination skill • Clear understanding of the task • Supervised practice • Direct experience • Repetition • Persistence

  14. Teaching clinical skills in the hospital setting Teaching clinical skills in the hospital setting • Be on time • Insist that students arrive on time • Plan the clinical teaching session

  15. Teaching clinical skills in the hospital setting • Involve the patients • Inform the charge nurse • Involve all the students • Insist on a standard format

  16. Teaching clinical skills in the hospital setting • Use a problem –solving approach • Conduct discussion away from the patient • Do not try to do too much

  17. วงจรการสอนทางคลินิก การเตรียมพร้อม ประเมินผลการทดลองฝึกปฏิบัติ สรุปข้อสำคัญหลังพบผู้ป่วยสรุปข้อสำคัญก่อนนศ.พบผป. ช่วงพบผู้ป่วย

  18. CLINICAL COMPETENCIES • FACTUAL KNOWLEDGE • TECHNICAL SKILL • PROBLEM SOLVING SKILL • COMMUNICATION SKILL • MANNERS & ETIQUETTE

  19. You are driving a car. On one big storm night. You are passing a station.

  20. There are three people who are waiting for the bus One old lady who is dying. One doctor who saved your life before. One guy/lady who is someone you have been dreaming to get married to.

  21. You can only take one passenger, which one you will choose? Please explain your reason.

  22. " 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 dream!"

  23. 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.

  24. CLINICAL COMPETENCIES • FACTUAL KNOWLEDGE • TECHNICAL SKILL • PROBLEM SOLVING SKILL • COMMUNICATION SKILL • MANNERS & ETIQUETTE

  25. Bioethics • Informed consent • Confidentiality • Truth telling • Maternal-fetal conflict • Quality end of life care • Conflict of interest • etc

  26. Education cycle Objective Learner Evaluation Learning experience

  27. Student evaluation • Multiple choice question • Modified essay question • Short/ Long case • Case report • Structured oral exam • Objective Structured Clinical Examination • OSLER • Direct observation: check list, rating scale • Standardized patient

  28. 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

  29. Good night

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