Are you in a hurry?A SHORT LECTURE ON

A QUICK TEACHING METHOD & A RAPID EVALUATION METHOD

Heizel Manapat-Reyes, MD, MHPEd, FPCP, FPRA

http://images.clipartpanda.com/doctor-bag-clipart

Harden & Crosby, AMEE Guide 20, Med Teach 22 (4)

Teaching should be

intentional. http://realestatetalk.com.au/wp-content/uploads/2014/02/wall-clock.jpg

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Evaluation should be

deliberate.

ONE MINUTE PRECEPTOR

5 Basic Teaching Skills

1. Set induction & Closure

2. Variability

3. Questioning

4. Reinforcement

5. Facilitatinghttp://thumbs.dreamstime.com/x/green-checklist-8400822.jpg

STEPS

Get a commitment

Probe for supporting evidence

Teach general rules

Reinforce what was done right

Correct errors

ONE-MINUTE PRECEPTOR

Get a Commitment

Goal: learner processes the information

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ONE-MINUTE PRECEPTORhttps://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcRjbctK1BEGzdfEBCLpwdRZ8gN8SyEcMSC9QqEmFiofxbzfOn3p

What do you think is going on?What do you want to do?

What tests will you ask for?How will you write your admitting orders?

Get a Commitment

Goal: learner processes the information

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ONE-MINUTE PRECEPTOR

May clarify information

but do NOT take over the case.

Try NOT to be inditimidating.

Probe for Supporting Evidence

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ONE-MINUTE PRECEPTOR

Goal: explore the learner’s mindmap

What is your basis for the diagnosis?

Why did you prioritize those tests?What factors did you consider in choosing those medications?

Probe for Supporting Evidence

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ONE-MINUTE PRECEPTOR

Goal: explore the learner’s mindmap

Do listen carefully.

May elaborate, if needed.

Teach General Rules

Focus on an important area

for the learner and the patient.

Choose generalizable rules than specific facts.

BREVITY is key.

Sometimes, assignments are necessary.

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ONE-MINUTE PRECEPTOR

Goal: target the lesson appropriately

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Reinforce what was done right

Verbal reinforcement of effective behaviors

Be specific.

May be done early to reduce learner performance anxiety. https://s-media-cache-

ak0.pinimg.com/736x/b2/dd/35/b2dd353c007f2a49e316e8b899998a50.jpg

ONE-MINUTE PRECEPTORhttp://www.athleteassessments.com/articles/images/feedback2.jpg

Correct Errors

Choose the setting

Start with self-evaluation of learner

Be specific

Be mindful of the language

ONE-MINUTE PRECEPTOR

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STEPS

Get a commitment

Probe for supporting evidence

Teach general rules

Reinforce what was done right

Correct errors

ONE-MINUTE PRECEPTOR

Let’s try it!

• Form triads.

• Choose who will be the teacher, learner and observer.

• Teacher & learner will discuss the case.

• Observer to give feedback on the interaction.

CASE:

55 yo/M, at the ER for acute onset of right knee arthritis with fever.

The knee is warm, erythematous & with effusion.

Patient on meds for diabetes, had gout in the past.

MINI-CLINICAL EXAMINATION

Miller’s Pyramid for Clinical Competence

MINI-CEX

Context-free MCQ exams

Case-based MCQ, essays, oral exams

Practical exams, OSCE, simulations

Workplace based

Mini-CEX

Focused observation of specific skills

Evaluates the learner in the workplace

Applied to various settings

Multiple observations over time (longitudinal assessment

Takes 5-30 minutes

MINI-CEXhttp://www.bma.org.uk/~/asset/4/13322.ashx?format=2%7C10000

Skills Evaluated tied to Oucomes

MINI-CEX

Medical Interviewing

Physical Examination

Counselling, informced decision making

Clinical judgment, reasoning

Over-all competence

MEDICAL INTERVIEWING

• Facilitates accurate collection of a patient's history

• Effectively uses questions/directions to obtain accurate information needed

• Responds appropriately to non-verbal cues

• Shows respect, compassion, empathy and establishes trust

• Attends to a patient's needs of comfort, modesty, confidentiality and information

PHYSICAL EXAMINATION

• Follows efficient, logical sequence

• Balances screening/diagnostic steps for problem

• Sensitive to a patient’s modesty and comfort

Demonstrates judgment, synthesis, caring, effectiveness and efficiency in patient care

MINI-CEX

COUNSELLING SKILLS

• Explains rationale for test/treatment, obtains a patient's consent

• Educates/counsels regarding disease management

• Discussion is prioritized, timely and concise

CLINICAL JUDGMENT

• Selectively orders/performs appropriate diagnostic studies

• Considers risks and benefits of prescribed treatment

Demonstrates judgment, synthesis, caring, effectiveness and efficiency in patient care

MINI-CEX

ABIM Mini-CEX Form

MINI-CEX

Rule Description

Correct positioning Avoid being in the line of sight of the learner & patientMake sure you can view techniques of the learner

Minimize external interruptions

Avoid taking routine calls

Avoid intrusions Don’t interject or interrup, if possibleExemption: trainee is giving wrong information

Be prepared Be focused on the goals of the encounter

SIMPLE RULES FOR OBSERVATIONS

Thank you.

Any questions?