This document discusses clinical physiotherapy education and teaching. It outlines several key challenges of clinical teaching including time constraints, unpredictable situations, engaging multiple levels of learners, and patient-related barriers. Excellent clinical teachers demonstrate clinical competence, clear organization, rapport building, and self-evaluation. Teaching in outpatient and inpatient settings each have their own difficulties such as brief interactions, priority of patient care, and unpredictable events. The document also reviews different learning styles, clinical teaching models, and tips for effective clinical teaching.

1. Subhash Khatri

2. Goal of Clinical Physiotherapy education is to produce the
PT we would like to see if we were sick!

8. Overview
 Clinical environment
 Focused on patient
 Problems, Diagnosis & Management
 Real life situations
 Decision making on time
 Apply theoretical & practical knowledge
 Acquire clinical skills

11. Challenges of Clinical Teaching
1. Time constraints
2. Work demands : clinical, research or administrative
3. Often unpredictable and difficult to prepare for
4. Engaging multiple levels of learners(PG/Interns/IV/III/II/I)
5. Patient related challenges: short hospital stays; patients
too sick or unwilling to participate in a teaching encounter
6. Lack of incentives and rewards for teaching
7. Physical clinical environment not comfortable for teaching

15. Skills that make a excellent clinical teacher
1. Share a passion for teaching
2. Are clear, organized, accessible, supportive and compassionate;
3. Are able to establish rapport; provide direction and feedback; exhibit
4. Integrity and respect for others
5. Demonstrate clinical competence
6. Utilize planning and orienting strategies
7. Possess a broad repertoire of teaching methods and scripts
8. Engage in self-evaluation and reflection
9. Draw upon multiple forms of knowledge, they target their teaching to
the learners’ level of knowledge.

17. Challenges in outpatient teaching
1. Busy clinical setting
2. Teaching time often short, no time for elaborate teaching
3. No control over distribution and organization of time
4. Attending to several patients at the same time with multiple learners
5. Brief teacher-trainee interactions
6. Patient care demands usually take priority and must be addressed
7. Multiple patient problems must be addressed simultaneously, so
8. teachers cannot focus on one problem to teach
9. Learning and service take place concurrently
10. Organic and psychosocial problems are intertwined
11. Diagnostic questions often settled by follow up of empiric treatment
12. Teacher should be a guide and facilitator than information provider

19. Challenges of inpatient teaching
 Difficult to set teaching goals, unanticipated events occur frequently
 Ward team usually composed of varying levels of learners
 Patients too sick or unwilling to participate in the teaching encounter
 Patient stays are too short to follow natural history of disease
 Teachers could compromise trainee-patient relationship if they dominate the
encounter
 Trainees and teachers feel insecure about admitting errors in front of the patient and
the rest of the medical team
 Tendency by many clinical teachers to lecture rather than practice interactive
teaching
 Engaging all learners simultaneously can be difficult
 Teachers need to pay close attention to learner fatigue, boredom and workload

21. Education is not teaching what learners doesn’t know but
making them to behave as they don’t behave!

29. Learning styles
Cognitive approach
1. Pragmatists
2. Reflectors
3. Theorists
4. Activists

31. Learning styles
VAK model
1. Visual
2. Auditory
3. Kinesthetic

33. Learning styles
Outcomes of learning
1. Superficial learning
2. Deep learning

35. Clinical Teaching Models
1. Stanford Faculty Development:-
Promoting positive climate
Control of session
Communication of goals
Promoting understanding and retention
Evalution
Feedback
Promoting self directed learning

36. 2. Micro skills of Teaching(One-minute preceptor)
Five-step approach
Getting commitment
Probing for supportive evidence
Teaching general rules
Reinforcement
Correcting mistakes

37. 3. Dundees model

39. Problems with Clinical Teaching
 Lack of clear objectives and expectations
 Teaching pitched at the wrong level
 Focus on recall of facts rather than problem solving
 Lack of active participation by learners

42. Don’ts
1. Leave the student alone until asked to supervise
2. Correct the student's mistakes in front of patient
3. Fails to set time limit for clinical teaching activities
4. Give general answers to a specific question
5. Not approachable
6. Difficult person to summon for consultation/help
7. Fail to adhere to teaching schedule
8. Ask questions in threatening manner
9. Put down them(you don’t know this?)
10. Insecurity about up to date knowledge

44. Do’s (Practical Tips for clinical teacher)
1. Preparation
2. Planning
3. Orientation
4. Introduction
5. Observation
6. Interaction
7. Summarize
8. Debrief
9. Feedback
10. Plan for next interaction

45. We will wrap up here!