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Efeective clinical and practical skill teaching

Effective teaching is an abstract concept. This presentation likes to stress upon different avenues of teaching in bed side clinics.

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Efeective clinical and practical skill teaching

  1. 1. Effective teaching of Clinical skills Dr. Hironmoy Roy MD, MBA, DHM, FAIMER (2015) MHPE, MIPHA, MNAMS
  2. 2. “ The end of education, especially professional education is Not knowledge but appropriate action”
  3. 3. "Having studied the Science Having grasped the meaning Having acquired the skills Having operated on dummies And with ability to teach the science, a Physician should enter the profession”.
  4. 4. Skill " An ability and capacity acquired through deliberate, systematic and sustained effort to smoothly and adaptively carry out complex activities or job functions involving ideas (cognitive skills), things (technical skills) and /or people (interpersonal skills).
  5. 5. Skill- types Intellectual skill To think in a desirable way- underlining component is knowledge e.g. - Ability to interpret liver function test results of a patient with jaundice
  6. 6. Skill- types Psycho-motor Skill Manual abilities needed towards diagnosing and treating patients e.g. - Ability to obtain a blood sample by venepuncture
  7. 7. Skill- types Communication skill Ability to communicate with others in a given situation. Strong underlying component is attitude e.g. - Ability to motivate relatives for blood donation.
  8. 8. Skill- types Team Skill Ability to work together in a team e.g. - Ability to work towards implementing a project/ operating on a patient with the team.
  9. 9. Current trends of teaching “skill” Master- apprenticeship model • ‘ See one, do one’- heralds problems • Knowing and watching a procedure does not mean one can perform it • Passive observation rather than active • participation of learners
  10. 10. Master- apprenticeship model
  11. 11. Master- apprenticeship model
  12. 12. The “master is the model”, who directs, demonstrates, comments, inspires & The “apprentice is the disciple”, who, listens, watches, imitates, does and seeks approval
  13. 13. Problems in teaching clinical skill Lack of clear objectives Large number of students Teacher has “no time” (load of patient/practice) Students are not interested (more to MCQ) Not explicit in the curriculum/syallabus Not standardized across schools Over-burdening with content information Inadequate supervision and feedback Little opportunities for reflection and discussion Clinical teaching not given high priority
  14. 14. Then, why to emphasise on learning of skill? • Growing mistrust among public for medical profession (cases of negligence, misconduct, and unethical practices) • Performance emphasis is increasing at all levels of our professional activity • Greater public understanding and enhanced patient’s rights • Medical school skills education has been slipping down
  15. 15. Teaching “Skill” Where? How?
  16. 16. How u learnt?
  17. 17. Instructor does & describes Instructor does, while the student describes The student does & describes (under supervision) ; receives feedback The student practice his own The student does his own
  18. 18. Unaware Incompetence Aware Incompetence Conscious Competence Reflex (Unconscious) Competence Awareness Training Practice
  19. 19. Teaching “Skill” Where? Work place Skill lab How?
  20. 20. Work place based training
  21. 21. Work place based training
  22. 22. Work place based training
  23. 23. Work place based training
  24. 24. Work place based training
  25. 25. Skill lab
  26. 26. Skill lab
  27. 27. Skill Lab
  28. 28. Skill Lab
  29. 29. Skill lab
  30. 30. Simulation……advantage or disadvantage? Advantage • Practice in a safe, protected • environment • Decreases risk to patients • Enables deliberate practice • Is safe to learn from errors • Scenarios can be reproduced • Rarely encountered important clinical accidents e.g. Anaphylaxis • Technical as well as non-technical skills can be practiced • Skills assessed in objective and reproducible manner Disadvantage • No real life feeling • Students may not feel comfortable in real-life settings • Over-protection makes handicapped • Students not get aware of the real life ‘side-effects’
  31. 31. Finally, while to plan the teaching on clinical skills….. Objective • What to teach? Settings • Whom to teach? • Where to teach? • How to teach? Execute • Implement • Feedback
  32. 32. "Education is Not Teaching students what they do not know but Making them behave as they do not behave” -----Ruskin Bond
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Effective teaching is an abstract concept. This presentation likes to stress upon different avenues of teaching in bed side clinics.

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