This document provides guidance to faculty on providing effective feedback to medical students in the emergency department setting. Some key points:
1) Feedback should be ongoing, immediate, and focused on specific behaviors, with the goal of changing poor habits or sustaining good ones.
2) Feedback discussions should reference clerkship objectives and be limited to a few points to avoid overwhelming students.
3) Feedback should include both praise for what students do well and constructive suggestions for improvement. Criticisms should be specific and avoid personal attacks.
4) Providing feedback is an important skill for faculty that can be developed through training programs focused on techniques like giving feedback "on the run" in clinical settings.
Process recording is a method where students record all verbal and non-verbal communications during a patient interview. It has four parts: verbatim dialogue, feelings and reactions, observations and analysis, and final comments. The verbatim dialogue provides a clear picture of the student-patient exchange. Feelings and reactions demonstrate the student's affective responses. Observations and analysis allow students to critically think about the patient's words and behavior. Final comments provide feedback from the clinical instructor. The purpose is to help students conceptualize activities, improve writing and self-awareness, and identify strengths and weaknesses. Advantages include differentiating thoughts and feelings, while disadvantages include time consumption for instructors.
The document discusses bedside clinics in nursing education. It defines bedside clinic as a process where a clinical teacher and students examine a patient together to discuss diagnosis, management, and care. The purposes are to provide learning experiences for students to identify patient problems and plan appropriate nursing care. The method involves preparation, introduction, discussion, and evaluation phases. Conducting bedside clinics helps develop students' clinical skills while allowing them to prepare and apply knowledge, but it also risks disturbing patients' privacy.
Social case work recording involves documenting a client's history, treatment, and services provided. It serves several important purposes: to facilitate service delivery, act as a teaching tool, and ensure continuity of care. The principles of recording include accuracy, objectivity, simplicity, clarity, and brevity. Records should contain identifying details, referral information, assessments, services provided, and a closing summary. Forms of records include process notes, summaries, standardized forms, and case notes. Recording has advantages like accountability, research, and continuity of care when workers change.
Program instruction and modes of clinical teachingsakshi rana
This document discusses clinical teaching methods in nursing. It provides information on essentials for good clinical instruction such as selecting clinical areas that allow students to practice high standards of nursing care. The principles of clinical instruction are establishing clear purpose and issues to be covered, knowing students, providing privacy and time, and having good listening skills. The functions of clinical instructors include setting objectives and standards, developing evaluation tools, and assisting with patient care. Qualities of good clinical instructors are enjoying bedside nursing and having strong communication and teaching skills. Various clinical teaching methods are also outlined such as conferences, bedside clinics, and case studies.
Bed side clinics are teaching sessions conducted at a patient's bedside where a clinical teacher and learners examine the patient, discuss their condition and treatment, and related nursing care. The goal is to illustrate common nursing problems associated with specific diseases or disorders. During a bed side clinic, instructors first obtain the patient's permission before examining them. The instructor or students then lead a discussion of the patient's provisional diagnosis and therapeutic options. The clinic concludes with the instructor summarizing key points and receiving feedback from students.
Clinical teaching method - Essentials in M.Sc NursingChithraValsan
Nursing is an art and science. Each member of the nursing field should possess certain qualities and characters.These are achieved from different ways, in which clinical teaching plays an important role in developing talented Nurses to the world. Clinical teaching method is method of group conference conducted especially in the clinical settings.Either individualized or group teaching is provided to the nursing students in the clinical area by the nurse educators, staff nurse or the clinical nurse manager.The main purpose is to develop nursing student as a technically competent, creative, systematic , assertive, accountable, intelligible, and independent to perform nursing care with confidence.Certain factors are directly or indirectly influencing the clinical teaching. Effective clinical teaching based on the appropriate selection of Clinical teaching method. Nursing care plan, bedside clinic, nursing care conference, nursing rounds , case method, demonstration are some of the common clinical teaching method.Along with brain storming,field visiting like methods creates interest among the student.
The document discusses clinical teaching methods in nursing education. Clinical teaching provides students the opportunity to apply theoretical knowledge to real patient care situations. It aims to help students develop communication, technical, and critical thinking skills. Some key clinical teaching methods mentioned include bedside clinics, nursing rounds, demonstrations, and field trips. These methods allow students to actively engage with patients and practice skills in a small group setting with close teacher supervision. Clinical teaching complements classroom learning by focusing on developing students' competencies for delivering holistic, patient-centered care.
November 2016 Nursing clinics. Essential characteristics nurse clinics and s...Linda Nazarko
This document discusses nurse-led clinics and essential characteristics of advanced nursing practice. It begins by outlining the learning objectives which are to understand how nurse-led clinics fit within advanced nursing practice, determine the characteristics of nurse-led clinics, and understand how to promote the value of nurse-led services. The document then defines advanced nursing practice and discusses core competencies. It addresses the types of nurse-led clinics and services, essential criteria for clinics, and effectiveness and evidence demonstrating positive outcomes of nurse-led care. The presentation emphasizes that advanced nursing practice contributes to developing the nursing profession while enriching patient care.
Process recording is a method where students record all verbal and non-verbal communications during a patient interview. It has four parts: verbatim dialogue, feelings and reactions, observations and analysis, and final comments. The verbatim dialogue provides a clear picture of the student-patient exchange. Feelings and reactions demonstrate the student's affective responses. Observations and analysis allow students to critically think about the patient's words and behavior. Final comments provide feedback from the clinical instructor. The purpose is to help students conceptualize activities, improve writing and self-awareness, and identify strengths and weaknesses. Advantages include differentiating thoughts and feelings, while disadvantages include time consumption for instructors.
The document discusses bedside clinics in nursing education. It defines bedside clinic as a process where a clinical teacher and students examine a patient together to discuss diagnosis, management, and care. The purposes are to provide learning experiences for students to identify patient problems and plan appropriate nursing care. The method involves preparation, introduction, discussion, and evaluation phases. Conducting bedside clinics helps develop students' clinical skills while allowing them to prepare and apply knowledge, but it also risks disturbing patients' privacy.
Social case work recording involves documenting a client's history, treatment, and services provided. It serves several important purposes: to facilitate service delivery, act as a teaching tool, and ensure continuity of care. The principles of recording include accuracy, objectivity, simplicity, clarity, and brevity. Records should contain identifying details, referral information, assessments, services provided, and a closing summary. Forms of records include process notes, summaries, standardized forms, and case notes. Recording has advantages like accountability, research, and continuity of care when workers change.
Program instruction and modes of clinical teachingsakshi rana
This document discusses clinical teaching methods in nursing. It provides information on essentials for good clinical instruction such as selecting clinical areas that allow students to practice high standards of nursing care. The principles of clinical instruction are establishing clear purpose and issues to be covered, knowing students, providing privacy and time, and having good listening skills. The functions of clinical instructors include setting objectives and standards, developing evaluation tools, and assisting with patient care. Qualities of good clinical instructors are enjoying bedside nursing and having strong communication and teaching skills. Various clinical teaching methods are also outlined such as conferences, bedside clinics, and case studies.
Bed side clinics are teaching sessions conducted at a patient's bedside where a clinical teacher and learners examine the patient, discuss their condition and treatment, and related nursing care. The goal is to illustrate common nursing problems associated with specific diseases or disorders. During a bed side clinic, instructors first obtain the patient's permission before examining them. The instructor or students then lead a discussion of the patient's provisional diagnosis and therapeutic options. The clinic concludes with the instructor summarizing key points and receiving feedback from students.
Clinical teaching method - Essentials in M.Sc NursingChithraValsan
Nursing is an art and science. Each member of the nursing field should possess certain qualities and characters.These are achieved from different ways, in which clinical teaching plays an important role in developing talented Nurses to the world. Clinical teaching method is method of group conference conducted especially in the clinical settings.Either individualized or group teaching is provided to the nursing students in the clinical area by the nurse educators, staff nurse or the clinical nurse manager.The main purpose is to develop nursing student as a technically competent, creative, systematic , assertive, accountable, intelligible, and independent to perform nursing care with confidence.Certain factors are directly or indirectly influencing the clinical teaching. Effective clinical teaching based on the appropriate selection of Clinical teaching method. Nursing care plan, bedside clinic, nursing care conference, nursing rounds , case method, demonstration are some of the common clinical teaching method.Along with brain storming,field visiting like methods creates interest among the student.
The document discusses clinical teaching methods in nursing education. Clinical teaching provides students the opportunity to apply theoretical knowledge to real patient care situations. It aims to help students develop communication, technical, and critical thinking skills. Some key clinical teaching methods mentioned include bedside clinics, nursing rounds, demonstrations, and field trips. These methods allow students to actively engage with patients and practice skills in a small group setting with close teacher supervision. Clinical teaching complements classroom learning by focusing on developing students' competencies for delivering holistic, patient-centered care.
November 2016 Nursing clinics. Essential characteristics nurse clinics and s...Linda Nazarko
This document discusses nurse-led clinics and essential characteristics of advanced nursing practice. It begins by outlining the learning objectives which are to understand how nurse-led clinics fit within advanced nursing practice, determine the characteristics of nurse-led clinics, and understand how to promote the value of nurse-led services. The document then defines advanced nursing practice and discusses core competencies. It addresses the types of nurse-led clinics and services, essential criteria for clinics, and effectiveness and evidence demonstrating positive outcomes of nurse-led care. The presentation emphasizes that advanced nursing practice contributes to developing the nursing profession while enriching patient care.
Clinical teaching involves individualized or group teaching of nursing students in clinical areas. It aims to bridge the gap between theoretical and clinical education. Various methods of clinical teaching are discussed, including bedside clinics, nursing care conferences, nursing rounds, and nursing care studies. Effective clinical teaching requires identifying barriers to learning, considering learning styles, collaborative planning, and creating a supportive learning environment. Evaluation of clinical teaching should be documented, valid, reliable, objective, comprehensive, and useful.
The document discusses various clinical teaching methods in nursing. It begins by outlining the general and specific objectives of the seminar on clinical teaching methods. It then defines key terms and introduces different clinical teaching models like the teaching model, preceptor model, and CTA model. The document also describes the components and purpose of nursing care plans, and explains the phases of bedside clinics in detail. Finally, it lists some commonly used clinical teaching methods in nursing like nursing care plans, case studies, bedside clinics, rounds, process recording, and group/individual conferences.
The document discusses various clinical teaching methods used in nursing education. It describes that clinical teaching focuses on meeting individual patient needs and understanding doctor's treatment orders. Some key clinical teaching methods discussed include nursing care conferences, observation methods, bedside clinics, nursing rounds, and demonstrations. Nursing care conferences involve group discussions about patient care. Observation methods allow students to learn through observing actual patient care. Bedside clinics involve examining a patient at their bedside and discussing their care.
This document discusses assessment and evaluation for improving student learning. It emphasizes that assessment should be for learning, not just evaluation. Effective formative assessment, including setting learning goals, success criteria, feedback, and self-assessment, can greatly improve student achievement. Teachers should plan assessment, instruction, and evaluation together to clearly define the learning goal and how students will demonstrate their knowledge and skills along the way. This helps ensure students understand expectations and monitors their progress towards successful learning.
This document discusses the importance of experiential and reflective learning for primary care physicians. It describes Kolb's experiential learning cycle and different levels of reflection. It also discusses portfolio-based learning and provides examples of content to include, such as learning logs, reflections on patient cases and educational events. The document provides guidance on identifying learning needs through methods like PUNs and DENs (patient unmet needs and doctor's educational needs), audits, and significant event analysis. Finally, it discusses how to develop a personal development plan to address identified learning needs through various learning activities and resources.
The document discusses the process of clinical evaluation for nursing students. It begins by defining evaluation and listing its purposes, which include assessing student performance, reinforcing good performance, and identifying areas for improvement. The document then explains the principles, participants, and steps involved in clinical evaluation. It describes various evaluation methods like observational techniques, written and oral communication methods. Finally, it discusses specific tools used in clinical evaluation like checklists, rating scales, and problem-oriented records.
The document discusses developing a learning trajectory for medical students on longitudinal rural clinical placements. It involved collecting feedback from past students and supervisors on key skills, knowledge, experiences, and responsibilities achieved at quarterly intervals. Analysis identified common learning goals at early, mid, and late stages. The learning trajectory is intended to guide students' learning pathways, support lost students or supervisors, and assist feedback. It provides examples of goals in history/exam skills, medical knowledge, professional experiences, and level of responsibility. The trajectory's development helped maximize learning opportunities and prepare students and supervisors for the rural placement.
This document discusses clinical physiotherapy education and teaching. It outlines the goal of clinical physiotherapy education as producing physiotherapists that teachers would want if they were sick patients. It describes the clinical environment, focus on patients, problem diagnosis and management. It also discusses challenges of clinical teaching like time constraints and engaging multiple levels of learners. Skills of excellent clinical teachers are outlined as well as challenges of inpatient and outpatient teaching. Different learning styles, clinical teaching models, problems and dos/don'ts of clinical teaching are also summarized.
Nursing rounds are meetings where nurses discuss patient care to improve outcomes. They have several purposes: to acquaint nurses with new patients, demonstrate procedures, illustrate skilled care, and teach about diseases and treatments. During rounds, the instructor briefs the nursing care of a selected patient while nurses and students observe and discuss care. Rounds ensure student autonomy, provide feedback, and help develop skills. They motivate risk assessment and case management learning. While rounds benefit teaching, disadvantages include potential patient discomfort overheard discussions and insufficient information limiting results.
This document provides tips and strategies for effective clinical teaching. It begins by defining clinical teaching as teaching that takes place in a clinical context and often involves patients and medical procedures. Some challenges of clinical teaching include a lack of clear objectives, teaching at the wrong level for learners, insufficient time for feedback and reflection. The document then recommends constructing lessons using the SET-DIALOGUE-CLOSURE model, where the teacher sets objectives, has a dialogue with learners, and provides closure through reflection and feedback. Specific techniques like the one-minute preceptor model are also presented to maximize teaching moments in clinical settings. The focus should be on developing learners' clinical reasoning skills over factual recall. Effective communication is emphasized throughout clinical teaching encounters
This document provides an overview of how to prepare for teaching residents in clinical settings. It discusses relating CanMEDS roles to rotation objectives and using models to determine appropriate teaching techniques and feedback. The document outlines several teaching techniques, including illness scripts, the one-minute preceptor method, case studies, and direct observation. It emphasizes the importance of reflection and improvement in teaching skills.
Margaret Penner has three professional nursing goals: to become an expert bedside nurse providing competent and compassionate evidence-based care through teamwork and relationships with patients; to affect positive change in her unit and institution through patient advocacy and championing evidence-based interventions and resources to improve patient safety, satisfaction and outcomes; and to promote women's health and provide cancer care to female patients by becoming a nurse practitioner specializing in oncology.
Nursing rounds involve a head nurse or teacher leading rounds with staff or students to understand patient conditions and the effects of nursing care. The purposes of rounds include observing patients' physical and mental states, staff work, introducing patients to personnel, carrying out care plans, evaluating treatment results, and teaching students. Rounds are conducted by discussing objectives outside patients' rooms first, then briefly visiting patients. Advantages are testing students' knowledge, benefiting informed students, orienting new nurses, and evaluating nursing activities and challenges. Disadvantages can include hampering confidentiality and distractions reducing attention. Standing orders provide emergency treatment guidance for areas without doctors by promoting temporary care until a doctor can be seen.
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.
This document discusses clinical teaching methods and adult learning principles. It begins by outlining learning outcomes which are to explain the learning environment, describe learning, list principles of adult learning, and describe different methods of clinical teaching. It then discusses principles of adult learning according to Knowles, including that adults are internally motivated, bring life experiences, are goal oriented, prefer relevance, and like to be respected. The document also lists various clinical teaching methods such as nursing conferences, demonstrations, case studies, role plays, and ward rounds. It concludes by summarizing the key topics covered.
This document discusses key concepts for patient assessment and communication in medical imaging. It emphasizes the importance of critical thinking, problem solving, cultural awareness and establishing effective communication. The radiographer must collect subjective and objective data on the patient, analyze the data to develop a customized care plan, implement the plan and evaluate the results. Nonverbal communication, gender factors and other variables that could impact the patient experience are also addressed.
The document discusses nursing rounds and reports. Nursing rounds involve a small group of nursing professionals and students gathering at a patient's bedside to discuss care, ensuring efficient nursing care and teaching students. Rounds provide learning experiences for students. Nursing reports communicate information about patient care between shifts and healthcare team members. Reports avoid duplication of work and indicate team efficiency. Types of reports discussed include oral, written, change of shift, transfer, incident, and evaluation reports.
The lecture presents skills and requirements of the initial interview in dental clinic, how could dentist gain patient rapport and patient's required information to reach diagnosis also identifying pits and errors of initial interview
Patient teaching, also known as patient education, involves informing patients to secure informed consent and promote patient compliance. The nurse's role includes assessing learning needs, developing objectives, planning and implementing teaching, evaluating learning, and documenting the process. Key aspects of patient teaching include maintaining health, preventing illness, and teaching patients to manage their condition. The teaching process considers the patient's educational background, health perceptions, and knowledge. Nurse educators must plan teaching appropriately and be available for incidental lessons.
The document outlines several goals and strategies for clinical nursing education, including:
1) Applying theory to patient care, communicating effectively, performing safe interventions, and exhibiting caring behaviors.
2) Setting clear expectations for students and providing structure to assist with accountability, responsibility, and professionalism.
3) Employing various teaching strategies like demonstrations, questioning, case studies, and reflective journaling to promote critical thinking and learning.
4) Guiding students' clinical experiences through establishing goals and objectives for each experience.
This document summarizes the diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in the emergency department. It describes a case of a 66-year-old man presenting to the emergency department with chest pain. Upon arrival, his EKG shows ST elevations consistent with STEMI. The document reviews the importance of rapid diagnosis and treatment of myocardial infarction in the emergency department setting. It also lists the learning objectives of being able to manage STEMI using evidence-based practices and use a methodological approach to patients at high risk of infarction.
Clinical teaching involves individualized or group teaching of nursing students in clinical areas. It aims to bridge the gap between theoretical and clinical education. Various methods of clinical teaching are discussed, including bedside clinics, nursing care conferences, nursing rounds, and nursing care studies. Effective clinical teaching requires identifying barriers to learning, considering learning styles, collaborative planning, and creating a supportive learning environment. Evaluation of clinical teaching should be documented, valid, reliable, objective, comprehensive, and useful.
The document discusses various clinical teaching methods in nursing. It begins by outlining the general and specific objectives of the seminar on clinical teaching methods. It then defines key terms and introduces different clinical teaching models like the teaching model, preceptor model, and CTA model. The document also describes the components and purpose of nursing care plans, and explains the phases of bedside clinics in detail. Finally, it lists some commonly used clinical teaching methods in nursing like nursing care plans, case studies, bedside clinics, rounds, process recording, and group/individual conferences.
The document discusses various clinical teaching methods used in nursing education. It describes that clinical teaching focuses on meeting individual patient needs and understanding doctor's treatment orders. Some key clinical teaching methods discussed include nursing care conferences, observation methods, bedside clinics, nursing rounds, and demonstrations. Nursing care conferences involve group discussions about patient care. Observation methods allow students to learn through observing actual patient care. Bedside clinics involve examining a patient at their bedside and discussing their care.
This document discusses assessment and evaluation for improving student learning. It emphasizes that assessment should be for learning, not just evaluation. Effective formative assessment, including setting learning goals, success criteria, feedback, and self-assessment, can greatly improve student achievement. Teachers should plan assessment, instruction, and evaluation together to clearly define the learning goal and how students will demonstrate their knowledge and skills along the way. This helps ensure students understand expectations and monitors their progress towards successful learning.
This document discusses the importance of experiential and reflective learning for primary care physicians. It describes Kolb's experiential learning cycle and different levels of reflection. It also discusses portfolio-based learning and provides examples of content to include, such as learning logs, reflections on patient cases and educational events. The document provides guidance on identifying learning needs through methods like PUNs and DENs (patient unmet needs and doctor's educational needs), audits, and significant event analysis. Finally, it discusses how to develop a personal development plan to address identified learning needs through various learning activities and resources.
The document discusses the process of clinical evaluation for nursing students. It begins by defining evaluation and listing its purposes, which include assessing student performance, reinforcing good performance, and identifying areas for improvement. The document then explains the principles, participants, and steps involved in clinical evaluation. It describes various evaluation methods like observational techniques, written and oral communication methods. Finally, it discusses specific tools used in clinical evaluation like checklists, rating scales, and problem-oriented records.
The document discusses developing a learning trajectory for medical students on longitudinal rural clinical placements. It involved collecting feedback from past students and supervisors on key skills, knowledge, experiences, and responsibilities achieved at quarterly intervals. Analysis identified common learning goals at early, mid, and late stages. The learning trajectory is intended to guide students' learning pathways, support lost students or supervisors, and assist feedback. It provides examples of goals in history/exam skills, medical knowledge, professional experiences, and level of responsibility. The trajectory's development helped maximize learning opportunities and prepare students and supervisors for the rural placement.
This document discusses clinical physiotherapy education and teaching. It outlines the goal of clinical physiotherapy education as producing physiotherapists that teachers would want if they were sick patients. It describes the clinical environment, focus on patients, problem diagnosis and management. It also discusses challenges of clinical teaching like time constraints and engaging multiple levels of learners. Skills of excellent clinical teachers are outlined as well as challenges of inpatient and outpatient teaching. Different learning styles, clinical teaching models, problems and dos/don'ts of clinical teaching are also summarized.
Nursing rounds are meetings where nurses discuss patient care to improve outcomes. They have several purposes: to acquaint nurses with new patients, demonstrate procedures, illustrate skilled care, and teach about diseases and treatments. During rounds, the instructor briefs the nursing care of a selected patient while nurses and students observe and discuss care. Rounds ensure student autonomy, provide feedback, and help develop skills. They motivate risk assessment and case management learning. While rounds benefit teaching, disadvantages include potential patient discomfort overheard discussions and insufficient information limiting results.
This document provides tips and strategies for effective clinical teaching. It begins by defining clinical teaching as teaching that takes place in a clinical context and often involves patients and medical procedures. Some challenges of clinical teaching include a lack of clear objectives, teaching at the wrong level for learners, insufficient time for feedback and reflection. The document then recommends constructing lessons using the SET-DIALOGUE-CLOSURE model, where the teacher sets objectives, has a dialogue with learners, and provides closure through reflection and feedback. Specific techniques like the one-minute preceptor model are also presented to maximize teaching moments in clinical settings. The focus should be on developing learners' clinical reasoning skills over factual recall. Effective communication is emphasized throughout clinical teaching encounters
This document provides an overview of how to prepare for teaching residents in clinical settings. It discusses relating CanMEDS roles to rotation objectives and using models to determine appropriate teaching techniques and feedback. The document outlines several teaching techniques, including illness scripts, the one-minute preceptor method, case studies, and direct observation. It emphasizes the importance of reflection and improvement in teaching skills.
Margaret Penner has three professional nursing goals: to become an expert bedside nurse providing competent and compassionate evidence-based care through teamwork and relationships with patients; to affect positive change in her unit and institution through patient advocacy and championing evidence-based interventions and resources to improve patient safety, satisfaction and outcomes; and to promote women's health and provide cancer care to female patients by becoming a nurse practitioner specializing in oncology.
Nursing rounds involve a head nurse or teacher leading rounds with staff or students to understand patient conditions and the effects of nursing care. The purposes of rounds include observing patients' physical and mental states, staff work, introducing patients to personnel, carrying out care plans, evaluating treatment results, and teaching students. Rounds are conducted by discussing objectives outside patients' rooms first, then briefly visiting patients. Advantages are testing students' knowledge, benefiting informed students, orienting new nurses, and evaluating nursing activities and challenges. Disadvantages can include hampering confidentiality and distractions reducing attention. Standing orders provide emergency treatment guidance for areas without doctors by promoting temporary care until a doctor can be seen.
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.
This document discusses clinical teaching methods and adult learning principles. It begins by outlining learning outcomes which are to explain the learning environment, describe learning, list principles of adult learning, and describe different methods of clinical teaching. It then discusses principles of adult learning according to Knowles, including that adults are internally motivated, bring life experiences, are goal oriented, prefer relevance, and like to be respected. The document also lists various clinical teaching methods such as nursing conferences, demonstrations, case studies, role plays, and ward rounds. It concludes by summarizing the key topics covered.
This document discusses key concepts for patient assessment and communication in medical imaging. It emphasizes the importance of critical thinking, problem solving, cultural awareness and establishing effective communication. The radiographer must collect subjective and objective data on the patient, analyze the data to develop a customized care plan, implement the plan and evaluate the results. Nonverbal communication, gender factors and other variables that could impact the patient experience are also addressed.
The document discusses nursing rounds and reports. Nursing rounds involve a small group of nursing professionals and students gathering at a patient's bedside to discuss care, ensuring efficient nursing care and teaching students. Rounds provide learning experiences for students. Nursing reports communicate information about patient care between shifts and healthcare team members. Reports avoid duplication of work and indicate team efficiency. Types of reports discussed include oral, written, change of shift, transfer, incident, and evaluation reports.
The lecture presents skills and requirements of the initial interview in dental clinic, how could dentist gain patient rapport and patient's required information to reach diagnosis also identifying pits and errors of initial interview
Patient teaching, also known as patient education, involves informing patients to secure informed consent and promote patient compliance. The nurse's role includes assessing learning needs, developing objectives, planning and implementing teaching, evaluating learning, and documenting the process. Key aspects of patient teaching include maintaining health, preventing illness, and teaching patients to manage their condition. The teaching process considers the patient's educational background, health perceptions, and knowledge. Nurse educators must plan teaching appropriately and be available for incidental lessons.
The document outlines several goals and strategies for clinical nursing education, including:
1) Applying theory to patient care, communicating effectively, performing safe interventions, and exhibiting caring behaviors.
2) Setting clear expectations for students and providing structure to assist with accountability, responsibility, and professionalism.
3) Employing various teaching strategies like demonstrations, questioning, case studies, and reflective journaling to promote critical thinking and learning.
4) Guiding students' clinical experiences through establishing goals and objectives for each experience.
This document summarizes the diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in the emergency department. It describes a case of a 66-year-old man presenting to the emergency department with chest pain. Upon arrival, his EKG shows ST elevations consistent with STEMI. The document reviews the importance of rapid diagnosis and treatment of myocardial infarction in the emergency department setting. It also lists the learning objectives of being able to manage STEMI using evidence-based practices and use a methodological approach to patients at high risk of infarction.
The document discusses the challenges of conducting research in the emergency department of a provincial hospital in Thailand. It notes that emergency physicians have limited time and resources to perform research due to heavy patient loads and understaffing. However, the document argues that research is still possible and can help improve patient care, develop leadership skills, and strengthen the hospital through an evidence-based approach. It provides tips for overcoming obstacles to research, such as finding a research question, supervisor, or ways to study issues found in daily work.
This document provides a list of 143 free online e-books covering various topics including biology, chemistry, medicine, physics, psychology and more. The e-books are from reputable sources like universities and provide comprehensive textbooks and guides on their subject matter that can be accessed for free online through the provided URLs.
This document outlines a clinical teaching program in obstetrics and gynecology (OBG) nursing. It discusses various teaching methods used in clinical education such as bedside teaching, nursing rounds, demonstrations, and nursing care studies. It also covers the responsibilities of clinical preceptors such as setting objectives, evaluating students, demonstrating procedures, analyzing difficulties, and maintaining student records. The document provides guidelines for selecting teaching materials and the qualities of effective clinical preceptors such as competence, respect, organization, and limiting content. Common clinical teaching models like one minute preceptor, SNAPPS, and pattern recognition are also summarized.
This document outlines the goals of clinical nursing education, which include applying theoretical learning to patient care situations, developing communication skills, demonstrating safe nursing interventions, showing caring behaviors, considering ethics, and experiencing various nursing roles. It discusses challenges students face in transitioning from classroom to clinical settings and the role of clinical instructors in addressing these issues. Specifically, it explores helping students reduce anxiety, enhance critical thinking, improve communication skills, and learn to integrate caring, technical skills, and intellectual components of nursing.
A Successful Faculty Development Program For Implementing A Sociocultural EPo...Angel Evans
This document describes a faculty development program to train faculty in using an ePortfolio assessment tool (SePAT) to evaluate medical students' progress in sociocultural competence. Key points:
- Three faculty development workshops were held to teach faculty how to use the new ePortfolio technology and provide structured, mentored feedback to student essays through the ePortfolio.
- Workshops included hands-on practice with the ePortfolio, developing criteria for effective feedback, reviewing sample student essays, and practicing providing written feedback.
- The workshops aimed to give faculty skills in assessing less tangible competencies like cultural awareness, and in providing individual feedback to large numbers of students through the ePortfolio system.
Program required by St. Clair County Community College in order for their students to mentor/ride along during his/her Basic EMT or Paramedic Program. Covers rules and regulations monitored by the college and addresses expectations of student and preceptor.
Program required by St. Clair County Community College in order for their students to mentor/ride along during his/her Basic EMT or Paramedic Program. Covers rules and regulations monitored by the college and addresses expectations of student and preceptor.
How to get the most out of assessment through feedbackr_ajjawi
This document discusses feedback in medical education assessment. It begins by defining formative and summative assessment and explaining that feedback is valuable for both. Feedback is defined as information comparing a trainee's performance to a standard in order to improve. While feedback is seen as important, there is often a "feedback gap" where educators feel they provide more feedback than students perceive receiving. This gap can be bridged through actively involving students in feedback dialogues, with self-review, peer-review and discussion of standards. Both teacher and learner strategies are needed to improve the feedback process.
This document discusses assessment methods in medical education. It defines competence as the habitual use of skills like communication, knowledge, reasoning, and reflection to benefit patients. Competence is developmental, contextual, and content-specific. Assessment goals are to guide learning, protect the public, and select trainees. Common assessment methods include written exams, direct observation, simulation, and multisource feedback. Each method has strengths and limitations, so using multiple methods over time provides a better evaluation.
This 3-sentence summary provides the essential information about the course outline:
This course outline summarizes a Fundamentals of Nursing Practice course, which introduces foundational nursing concepts over 18 weeks including the nursing process, basic skills, ethics, and professional development. Students will learn through lectures, skills labs, assignments and exams to develop competencies in areas like health assessment, care planning, communication, and clinical reasoning. The course aims to prepare students for nursing practice through applying knowledge and demonstrating skills in a holistic manner.
Chnaging trends in Medical Education Oct 23.pptxRajan Duda
Teaching : Latest concepts in medical education
how best to optimize medical education
new trends in undergraduate and post graduate teaching in pediatrics
This document describes an interdisciplinary project between colleges of pharmacy, nursing, and allied health sciences at a university to introduce concepts of professionalism to health professions students. The project included an orientation and field experience. Survey results from both components indicated that the project was valuable in increasing students' awareness of the importance of professionalism in clinical settings and the contributions of different professions to healthcare teams. The goal was to provide opportunities for interdisciplinary learning to enhance collaboration and professionalism among future healthcare professionals.
This document provides guidance and information for field preceptors working with EMS students. It outlines the roles and responsibilities of preceptors and students, including providing feedback, evaluating students, and documenting encounters and skills practice using the FISDAP program. Preceptors are instructed to orient students to each shift, supervise skills and allow increased responsibility over time, and provide feedback both verbally and through formal evaluations completed via FISDAP at the end of each shift. The goal is for students to develop clinical competency under the guidance of knowledgeable preceptor mentors.
The document discusses stress experienced by nursing students. It notes that nursing students experience higher levels of stress than students in other programs like medicine, social work, and pharmacy. Sources of stress for nursing students include their learning experiences, which involve 24 hours per week spent in clinical duties like patient interaction and procedures. Stress can negatively impact students' performance and mental health, causing issues like burnout, illness, and even suicidal thoughts in some cases. While many students experience stress, most are able to graduate on time, suggesting they utilize effective stress management techniques. The study aims to understand the relationship between stress levels and stress management techniques used by nursing students during their clinical learning experiences.
Clinical teaching provides opportunities for nursing students to apply theory in practice settings. It aims to develop students' skills, problem-solving, and cultural competence. Traditional models involve instructors accompanying groups of students who are assigned patients. Preceptorship models pair a student with a practicing nurse for supervision and guidance.
Effective clinical instruction requires preparation like selecting sites, identifying units, and arranging student assignments. During sessions, preconferences orient students and postconferences allow analysis and evaluation. Formative and summative evaluations provide feedback and assess competencies in areas like critical thinking and documentation. Evaluation tools must be clear, measurable, and practical for improving student learning in clinical placements.
The Value of Competency-based Medical Education Across the ContinuumMedCouncilCan
The document discusses competency-based medical education across the continuum of training. It begins by outlining the speaker's conflicts of interest in assessment-related organizations. The objectives are then stated as discussing the roles of assessment in a competency-based program, developing approaches to effective assessment, and integrating assessment into Memorial University's education system. Milestones and entrustable professional activities are presented as frameworks to assess competency development longitudinally. Challenges of assessment across training levels and principles of competency-based assessment are also addressed.
Standardized Clinical Placement
Amanda Swenty
MSN-Learner
Walden University
NURS 6600
April 30, 2016
Introduction
Summary of Practicum Project Topic
Project Goals
Project Objectives
Rationale for Goals
Practicum Project Methodology
Practicum Project Findings
Conclusion
I would like to welcome the faculty and course members to this presentation of a topic that I am passionate about as a current faculty member. This project will explain in detail the need for a standardized placement tool for academic settings and hospitals to use.
2
Current difficulty placing students in the clinical setting
Limited sites for faculty led/preceptor led clinical
Disorganized Process of placement of students
Current placement is done individually by each site and it time intensive
Current process shows favoritism
Summary of Practicum Project Topic
As a former student I have felt the pains of placement for students in the clinical setting. As a faculty member I have been exposed to the difficulties that placing students has placed on the colleges and faculty, and the hospitals that host students. The difficulties are in the following areas:
Lack of qualified faculty willing to be flexible in unique clinical times (weekends/nights)
Poor communication between the school/hospital
Time extensive placement for current process ( School sends a request, hospitals wait for requests from all colleges before approving, placement approvals/denial sent back to college). This process can take up to months for a response.
Due to the poor communication sites are limited as managers don’t respond timely so sites go without students on site
The faculty from each college and placement coordinators from each hospital all meet monthly to discuss process. At this meeting it was discovered that one hospital places favoritism to the college associated with them and also the technical college as they have tenure with them. This makes fair placement an issue.
In the Greater Green Bay Healthcare Alliance meeting I presented the proposed topic for approval on April 8, 2016. The above listed issues were discussed and all members agreed to provide data to make placement a standardized process. All faculty and placement coordinators agree to provide all data available to create a useful tool that can be used by all members for student clinical placement.
3
Project Goals
Gather all necessary information to create an effective standardized placement tool
Create a standardized student placement tool
Presentation approved by the Greater Green Bay Health Care Alliance
Successful completion of this course to better prepare me for this advanced degree in nursing
The project goals that I have set for this project are related to the creation of a standardized tool that can be useful for academic setting and healthcare facilities to use to place students in the clinical setting. As listed in the introduction the current process lacks organization, standardiz.
1. The document discusses various aspects of clinical teaching methods for nursing students, including definitions, objectives, types of clinical teaching, and guidelines.
2. Some key types of clinical teaching methods discussed are nursing case studies, nursing case presentations, nursing rounds, bedside nursing clinics, nursing assignments, and nursing care conferences.
3. Effective clinical teaching methods should align with learning objectives and promote the development of students' knowledge, skills, and attitudes to prepare them for nursing practice.
The document discusses the current method used for training nuclear medicine technologists in Ontario and provides suggestions for improving it. The current method involves students rotating through clinical sites where they are supervised by technologists as they perform procedures. The document proposes adding elements of reflective practice, where students and technologists debrief after abnormal cases, and adapting established clinical education models to the nuclear medicine context. This is intended to enhance students' learning and development of problem-solving skills when faced with unusual situations.
NDU Term Paper | Technical English For Business Communication ReportNaja Faysal
The document is a report on installing air conditioners at Notre Dame University based on a student survey. It finds that [1] 80% of students believe they would be more motivated to attend classes if classrooms were cooler, as physical comfort boosts energy and concentration. [2] 64% said air conditioning would lead to more class attendance. However, the students surveyed have varying experiences with air conditioning, so the university should further assess if cooling needs are real or perceived. The report recommends Notre Dame consider air conditioning to improve the learning environment and student commitment.
competency based education in nursing for msc nursing students in nursing education. It focuses more on the skill building of student nurse in education and also skill development of nursing teacher while teaching. It is not focused on the time consumption . Main aim is to make the nurse competent to increase the standards of care in nursing and also to provide better health care facilities. goal is to provide more competent nurses to health care system.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
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TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
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TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Cell Therapy Expansion and Challenges in Autoimmune Disease
Feedback
1. ACAD EMERG MED d December 2004, Vol. 11, No. 12 d www.aemj.org 1283.e1
Feedback
Barbara K. Richardson, MD
Abstract
The emergency department provides a rich environment for performing students. Although the following examples
diverse patient encounters, rapid clinical decision making, pertain to medical student education, these techniques are
and opportunities to hone procedural skills. Well-prepared applicable to the education of all adult learners, including
faculty can utilize this environment to teach residents and residents and colleagues. Specific examples of redirection
medical students and gain institutional recognition for their and reflection are offered, and pitfalls are reviewed.
incomparable role and teamwork. Giving effective feedback Suggestions for streamlining verbal and written feedback
is an essential skill for all teaching faculty. Feedback is and obtaining feedback from others in a fast-paced
ongoing appraisal of performance based on direct observa- environment are given. Ideas for further individual and
tion aimed at changing or sustaining a behavior. Tips from group faculty development are presented. Key words:
the literature and the author’s experience are reviewed to feedback; medical students; faculty development; emer-
provide formats for feedback, review of objectives, and gency medicine. ACADEMIC EMERGENCY MEDICINE
elements of professionalism and how to deal with poorly 2004; 11:1283.
The clerkship in emergency medicine (EM) should be may continue to disrupt shift flow and jeopardize
the pinnacle of student autonomy in the fourth year, patient safety.
a unique opportunity to amplify clinical skills and Faculty should keep in mind that they are role
medical decision making in preparation for intern- models for students and provide continuous feedback
ship. Integral to this transformation from student to as they interact with patients and families, residents,
physician is excellent feedback provided by faculty students, staff, and consultants. There is no better
and senior residents. However, like parents in child- place to learn how to prioritize tasks and patients,
rearing, faculty members are expected to perform well focus on the life threats, negotiate solutions, redirect
in this role with little advance training. the expectations of the patient and families to the
Ende1 defines feedback as an informed, nonevalu- possible, anticipate the complications, and efficiently
ative, and objective appraisal of performance that is arrive at an appropriate disposition than the emer-
aimed at improving clinical skills rather than estimat- gency department (ED). Students are great mimics
ing the student’s personal worth. Feedback differs and will copy the habits of their preceptors. The
from evaluation in that it is immediate and formative, ability to provide feedback and serve as a role model
rather than summative, and is directed toward en- is expected of all teaching faculty members.
hancing the student’s ability to modify and improve
their performance over time to meet the objectives of
the clerkship. Feedback is targeted to specific behav-
ELEMENTS OF EFFECTIVE FEEDBACK
iors the student does well and those in need of 1. Clerkship Goals and Objectives Should Be
improvement. The goal is to change a poor habit or Thoroughly Understood by Students and Precep-
sustain and augment effective behavior over time. To tors from the Beginning. Web sites and e-mails in
be most effective, feedback should be provided on advance of formal orientation sessions can facilitate
a continuous basis throughout the clerkship, at the this process. EM clerkships are generally designed as
end of a case or shift, and by the site director at the subinternships with expectation of student manage-
midpoint of the rotation. If the learner does not ment of a variety of acuities and presentations, re-
receive realistic feedback, then the wrong behaviors quired and optional procedures, mandatory didactic
sessions, recommended reading, oral or written case
discussions to foster lifelong learning, and a written
From the Department of Emergency Medicine, Mount Sinai Medical examination. During formal orientation, students are
Center (BKR), New York, NY. informed of the requirement to actively seek feedback
Received January 1, 2004; revision received March 12, 2004; during and at the conclusion of every clinical shift.
accepted May 3, 2004. Providing a feedback form to students for faculty
Address for correspondence: Barbara K. Richardson, MD, Depart- to complete that includes queries on a witnessed
ment of Emergency Medicine, Box 1620, Mount Sinai Medical
Center, One Gustave Levy Place, New York, NY. e-mail: barbara.
history and physical examination, observed proce-
richardson@msnyuhealth.org. dures, and a list of objectives including eliciting his-
doi:10.1197/j.aem.2004.08.036 tory and physical examinations, eliciting differential
2. 1283.e2 Richardson d FEEDBACK
diagnoses, ability to formulate a management plan, time to reflect on what happened and how they might
interpreting laboratory test results, performing pro- do it differently the next time.
cedures, and interacting with patients as well as room
for a narrative of strengths and weaknesses will 6. Feedback Should Be Specific and Limited to
provide a daily reminder of faculty responsibility a Few Objectives at a Time. The pace of events in the
and proof of student progress in the clerkship. It ED can be challenging to seasoned preceptors and
formalizes the student and faculty feedback loop and daunting to students. Feedback can be effectively
identifies faculty members over time who deserve done ‘‘on the run’’ as one reviews how a case is pro-
extra credit for their work or need more help with the gressing or the communication skill of a student in
process. conveying only essential information and the question
on a requisition or consult. Bedside supervision of
2. Students and Patients Must Have a Safe Learn- a procedure is an opportunity for verbal rehearsal in
ing Environment. Provide a safe setting for students advance of the procedure, followed by midcourse
to experience autonomy in data gathering and initial corrections as needed during the procedure. Often
evaluation of the patient. This is readily achieved in residents or nurses are invaluable preceptors for
the lower acuity areas of the ED where students are essential procedures because they have significant
encouraged to be the first ‘‘physician’’ beyond the recent experience in performance. Faculty must re-
triage desk. In the trauma bay and cardiac rooms, serve time at the end of the shift to review a few key
students are often involved in more peripheral tasks issues and provide for reflection by the student. These
or observer status; however, faculty must ensure that are not mini lectures, which have been shown to foster
learning issues and performance of students and dependence, but oriented to clinical skills and specific
residents are addressed once the patient has been observations.
stabilized.
7. A Format for Feedback. The sandwich technique
3. Students and Preceptors Must Share Mutual of good news, corrective action, and then good news
Respect. Show students the respect you would give has been promoted by some as a useful way to
to any other physician. Faculty interactions with provide feedback. Others believe that overemphasis
students and their patients at the bedside will on the positive may undermine appreciation for, and
strongly influence a student’s choice of subspecialty. attention to, the deficiency. Depending on the person-
Do not be condescending or overbearing in your ality of the student, some may hear only the negative
instruction or criticism of their talents. Respect their comment and lose confidence in their ability. Regard-
opinion as to the clinical status of the patient. Ask less of technique used, comments should be specific,
them to identify any areas of uncertainty. Underscore not personal (e.g., ‘‘ I noted you had trouble with the
the importance of honesty in all clinical interactions. ABG’’ rather than ‘‘You are completely incompetent at
Give them your undivided attention during their blood gases!’’).
presentations; resist the urge to interrupt frequently.
8. Label Feedback. Unless clearly stated, students
4. Feedback Should Be Timely. Constructive feed- will fail to recognize feedback and you will not be
back prevents poor first efforts from becoming bad recognized for your effort. Clearly identify your
habits. Reserve corrective actions whenever possible comments as constructive feedback on the perfor-
for private conversations. Global deficiencies in a stu- mance for that shift.2
dent should be brought early to the attention of the
clerkship director. 9. Dealing with a Student’s Response to Feedback.
Students with repeated problems should be inter-
5. Dealing with Poor Clinical Skills. A student may viewed in private. Students will be less defensive if
be an exhaustive reporter of medical data but unable the site or clerkship director explores the student’s
to organize the pertinent information for a concise perception of what is wrong and how he or she thinks
oral presentation or chart note. Systematizing the it could be improved. Students are often relieved to
approach driven by the chief complaint will improve learn that they can reform and still complete the
future performance. Students may lack confidence in course in a satisfactory manner. Misperceptions can
their clinical examination. Findings should be re- be dispelled. Students rotating through the ED post-
viewed at bedside. Offer to demonstrate findings and match to their subspecialty of choice may have a lack
procedures. More advanced students may require of motivation. Savvy preceptors should rejoice in their
help with task prioritization or selecting evidence- success but underscore the potential value of the
based therapeutic plans. It is useful to ask what they clerkship (makes the internship less daunting) and
would like to know/see, etc. Students exhibiting poor the consequences of not achieving the minimum
interpersonal skills with nurses or patients need objectives (failure to graduate on time). Serious in-
a private session with the preceptor to allow them terpersonal difficulties are unlikely to be a new issue
3. ACAD EMERG MED d December 2004, Vol. 11, No. 12 d www.aemj.org 1283.e3
by the fourth year of medical school. Discussions with d Give immediate feedback at the end of a shift or
the dean’s office may yield appropriate corrective patient interaction, not just at specified times.
actions. Students whose work appears to degenerate d Discuss criticisms with a student before writing
toward the end of the clerkship may have a legitimate them into a final evaluation.
reason, such as a family emergency or serious per- d Initiate feedback before students have to ask for it.
sonal health issue. Upon discovery, students will still
Feedback from faculty and senior residents will
be required to complete the clerkship, albeit in a more
differ in emphasis and rating but can provide valu-
relaxed time frame.
able insight into student performance. Residents tend
to rate students higher than faculty and focus on team
dynamics, work ethic, and procedural skills. Faculty
10. Legal and Illegal Criticisms. Limit feedback to
more often comment on fund of knowledge, reason-
remediable behavior. Preceptors who find themselves
ing, and communication skills.6,7
very angry with a student should take a five-minute
Faculty skills in feedback technique can be de-
timeout before providing criticism. By first soliciting
veloped in small group discussions, which include
feedback from the student, a positive message is
clerkship objectives, teaching tools, videotapes, and
conveyed that both student and preceptor can im-
critiqued role play.8 Starting with a needs assessment,
prove their communication, performance, etc.3 Re-
a program can be designed using lecture format, small
member that students may be as stressed as faculty
group discussions, and even standardized students to
during a particularly busy shift. Taking time out after
permit faculty to try out techniques and obtain valu-
your shift for a brief meal break or the next day to
able feedback from colleagues and mentors in a pro-
review some of the salient points that could not be
tected environment.
covered in real time will strengthen the bond with the
Residency directors in EM and other disciplines
student and heighten your credibility.
share the same interest in faculty development and
may invite national speakers with expertise in this
area. Departments or institutes of medical education
FACULTY DEVELOPMENT in medical schools can create interdisciplinary di-
Labeling all students as ‘‘phenomenal’’ may make you dactic and experiential sessions that focus on feed-
a popular preceptor but does little to assist the student back and other key issues in teaching. Faculty with
in identifying areas of weakness or help the site interest in teaching fellowships should consider
director to determine whether the objectives are being CORD’s Navigating the Academic Waters program,
met. Indirect comments, in an attempt to preserve the medical education programs (such as the one-month
student’s self-esteem or facilitate the active learning programs at Stanford University), Association of
process, may result in failure of the student to American Medical Colleges or Harvard Macy fellow-
recognize a medical error as an error.4 Faculty fears ships, or an advanced degree program (such as the
of student reprisal, failure to recruit students to the master’s in education offered at the University of
specialty, or even litigation are unfounded if feedback Illinois).
is respectful and based on objective observation.
Nonetheless, faculty may be unwilling to discuss HELPFUL HINTS AND EXAMPLES OF
marginal students on paper. Group meetings at FEEDBACK
regular intervals with faculty and residents who
supervise students are more likely to uncover serious 1. Student self-reflection.9 ‘‘What went well?’’
problems. Encourage calls from faculty if there are ‘‘What do you need to work on?’’ Solicit feedback
concerns. Clerkship and site directors will also find it from the student on their performance during
valuable to observe faculty–student interactions on an a particular encounter or shift. Although many
unannounced basis. students will tend to be overcritical, it gives the
Kernan et al.5 surveyed third-year students to faculty member insight into weaknesses the stu-
identify faculty behaviors that facilitated learning. dent is aware of as well as those the student has
Under the domain of feedback, 86%–97% of respond- not recognized. The faculty member can then
ents agreed with the following: suggest specifics on how to improve through
reading, study, skills, or practice.8
d Read notes promptly in the rotation to comment 2. Make specific observations. Pangaro10 developed
regarding form, content, and length. the R-I-M-E (Reporter–Interpreter–Manager–Edu-
d Do not stop at global criticism. Be specific and cator) construct to identify specific milestones in
directive, citing alternative ways of doing the student progress. Some examples follow.
pertinent skill.
d Tell students when they are doing something well.
d When an error is made, tell how to do it right; Feedback on Student as Reporter. ‘‘With Mrs.
when they do, compliment them. Smith, I thought you were pressured to complete
4. 1284.e4 Richardson d FEEDBACK
a thorough history on chest pain, which is important, not responded, what would your next step be? What
but you didn’t give her much time to tell you about will be important in the education of your patient?’’
the quality and character of the pain. How might that ‘‘You have arrived at the most likely diagnosis. In
change your index of suspicion for acute coronary emergency medicine, we must often make decisions
syndrome in this patient?’’ based on a limited data set and time with the patient.
‘‘I have observed that you do not routinely inquire Abdominal pain is a frequent presenting complaint and
about HIV status in patients with upper respiratory it is not possible or appropriate to perform exhaustive
complaints. If you agree that knowledge of HIV status workups on every patient. What danger signs will you
will affect your differential and treatment, where discuss with your patient to ensure prompt return if
might be a good place to work this into your history a more serious condition is unfolding?’’
taking?’’ ‘‘Your explanation to the asthma patient on how to
(Session following a corrective action) ‘‘Your effort avoid triggers and the proper way to use inhalers is
to make your presentation and chart more problem likely to improve patient well being and reduce
oriented has paid off! Your ability to focus on the further ED visits. You were smart to ask the patient
problem(s) and be concise in documentation will be to return a demonstration and describe her under-
a real timesaver during your internship and much standing of the discharge instructions.’’
appreciated by your colleagues and consultants.’’
3. One goal of the clerkship is to improve efficiency
Feedback on Student as Interpreter. ‘‘Your elder and focus in patient evaluation. A brief preview of
patient presents with a history of heart failure and the chief complaint and vital signs with the
bradycardia. Can you review your interpretation of student in advance of the patient evaluation will
the ECG and electrolytes again? Great! You have identify those students who will need earlier
correctly identified a ventricular escape rhythm and supervision and those patients who will need
hypokalemia. How might they be related? What else a team approach. Students are granted some
is in your differential?’’ autonomy with stable patients commensurate
‘‘You have done an admirable job on the history and with their experience. Students benefit most
physical examination in this patient with acute head- when faculty seek their input and confirm ques-
ache. In addition to what you believe to be the most tions or findings at the bedside, leaving students in
likely diagnosis, what are others, which you must control of the case. Patients are usually tolerant of
consider, in order not to miss a grave condition? What some delays that are inherent in this approach.
might be a good source in which to find this in- However, faculty must assume control of a case
formation?’’ whenever there is potential for harm to a patient.11
4. Interrater reliability will increase when multiple
Feedback on Student as Patient Manager and encounters are included.12 Ten to 16 or more
Educator. ‘‘Clarity in order writing is an important eight- to 12-hour shifts are easily incorporated
way to reduce medical errors. The nursing staff ex- into a three- to four-week clerkship. Students may
pects certain conventions. Let’s review your orders for get more valuable feedback if they work with the
Mr. Jones. The nurses are looking for drug, dose, same faculty member for the majority of shifts. In
route, and frequency.What source did you use to many departments, this is not possible due to
learn about this drug and decide upon the dose?’’ conflicting demands on faculty and the desire to
‘‘You have presented two patients today with expose students to a variety of teaching styles. It is
possible fractures. How might you reduce their always preferable to have a student present to the
discomfort in X-ray? Do you need a diagnosis before same faculty member on a given shift. Students on
administering pain medications? What would be ‘‘audition’’ electives should work several shifts
appropriate? Would you like to review the steps with at least one member of the residency selec-
before making a splint for this patient?’’ tion committee. The site or clerkship director
(After concern was voiced by the RN chaperone) determines which scenario works best in view of
‘‘Can you walk me through the techniques you use to the number of students in a particular block.
prepare a female patient for a pelvic exam? Would 5. Many faculty members believe that professional-
you like me to demonstrate how I do it?’’ ism is the most important aspect of student
‘‘I notice that the alcoholic patient you are inter- assessment. Faculty members are encouraged to
viewing is becoming quite agitated. It is a challenge to comment on maturity, responsibility, honesty, and
manage patients who are potentially disruptive. Let’s respect for patients and staff demonstrated or
step back for a moment and review what you know abrogated by the students. Do not permit or model
and what you think might be going on.perhaps you inappropriate negative comments about recidivist
should use a different approach.’’ or other challenging patients. Labeling can lead to
‘‘You did a great job recognizing and alleviating the gross negligence in patient care. Pejorative docu-
airway obstruction in your patient. Had the patient mentation is an invitation to litigation.
5. ACAD EMERG MED d December 2004, Vol. 11, No. 12 d www.aemj.org 1283.e5
6. Focus feedback on areas the student can control. and promote feedback on patient outcomes so essen-
Primary objectives to practice in EM include the tial to our personal performance improvement.
ability to establish and use a limited data set Clerkship directors are encouraged to explore
quickly, prioritize tasks, engage in conservative resources within and beyond their own institution to
diagnostic reasoning, and manage more than one assist in the development of excellent preceptors.
patient simultaneously. Negative comments on Regular meetings between sites and visits by the
speech defects or language difficulties are off limits. clerkship director to each site will help to maintain
7. Limit feedback to a few important observations. Do consistency and collaboration and reinforce the criti-
not attempt to create the quintessential EM student cal role of site faculty in the training of students.
in one session. Respect the fact that all students can Documentation of successful efforts in teaching stu-
gain enormous value from your teaching and this dents is critical to institutional recognition and in-
rotation. Accept that not all of them wish to emulate dividual faculty advancement.
you and become emergency physicians!
8. Be receptive to suggestions from students about
how to improve feedback. At our institution, References
students are required to submit anonymous eval- 1. Ende J. Feedback in clinical medical education. JAMA. 1983;
uations of the clerkship and faculty interactions in 250:777–81.
order to obtain their grades. There are electronic 2. Albritton TA. Feedback. In: Fincher RE (ed). Guidebook for
Clerkship Directors. Washington, DC: Association of American
systems that facilitate this labor-intensive work.
Medical Colleges, 2000, pp 135–8.
Evaluations are reviewed by the site directors and 3. Weinholtz D, Edwards J. Providing feedback. In: Mumford L
returned to individual preceptors at intervals to (ed). Teaching During Rounds: A Handbook for Attending
preserve confidentiality. Just as a single negative Physicians and Residents. Baltimore: Johns Hopkins Press,
comment is cause for concern regarding a student, 1992, pp 85–93.
several negative comments about a faculty member 4. Ende J, Pomerantz A, Erickson F. Preceptors’ strategies for
correcting residents in an ambulatory care medicine setting:
should be addressed through a private conference a qualitative analysis. Acad Med. 1995; 70:224–9.
or personalized faculty development session. 5. Kernan WN, Lee MY, Stone SL, Freudigman KA, O’Connor
PG. Effective teaching for preceptors of ambulatory care:
a survey of medical students. Am J Med. 2000; 108:499–502.
CLOSING COMMENTS 6. Metheny WP. Limitations of physician ratings in the
assessment of student clinical performance in an obstetrics and
Aside from being required by the Liaison Committee gynecology clerkship. Obstet Gynecol. 1991; 78:136–41.
on Medical Education, feedback is an integral part of 7. Hull AL. Medical student performance: a comparison of house
our role as faculty and clerkship directors. For some of officer and attending staff as evaluators. Eval Health Prof.
us with excellent observational and interpersonal 1982; 5:87–94.
8. Keenan JM, Seim HC, Bland CJ, Altemeier TM. A workshop
skills, this is an easy transition. For the rest, thor- program to train volunteer community preceptors. Acad Med.
oughly reviewing the goals of the clerkship, spending 1990; 65:46–7.
time directly observing the students in action, and 9. Woolliscroft JO, TenHaken J, Smith J, Calhoun JG. Medical
practicing active listening will produce better feed- students’ clinical self-assessments: comparisons with external
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