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QA Medical Education:Teaching Clinical Skills
Faculty of Medicine9 September 2008
Common Pitfalls with Clinical Teaching
• Lack of clear objectives and expectations• Focus on factual recall rather than on
development of problem solving skills and attitudes
• Teaching pitched at the wrong level• Passive observation rather than active
participation of learners• Inadequate supervision and feedback
Common Problems with Clinical Teaching
• Little opportunities for reflection and discussion
• More teaching in in-patient and tertiary-care setting
• Over-expectation on student competencies• Teaching by humiliation• Large number of students• Lack of preparation
Common Problems with Clinical Teaching
• Inadequate role models• Informed consent not sought from patients• Lack of respect for privacy and dignity of
patients• Patient safety• Incentives to patients
Outcomes of Clinical Education
1. Clinical knowledge2. Clinical skill3. Communication skill4. Clinical reasoning5. Practical procedures6. Patient investigation7. Data interpretation and retrieval
Outcomes of Clinical Education
8. Patient management 9. Health promotion and disease
prevention10. Professional skill11. Self-directed learning 12. Attitude and ethics
Common teaching methods in the hospital settings
1. Bedside teaching2. Logbook and Portfolio3. Task-based learning4. Problem-based learning5. Study guides6. Grand rounds7. Business ward round
8. Teaching ward round 9. Clinical conference10. Apprenticeship model11. Patients-centered model12. Shadowing a junior doctor13. Medical record writing14. Workshop
Common teaching methods in the hospital settings
Learning Environment in Clinical Settings
• Autonomy• Supervision• Social support• Workload• Role clarity• Variety• Orientation to learning and teaching• Orientation to general practice
Clinical Learning Cycle
Preparatory
Explanatory-Reflection-Feedback-Working knowledge
Experiential-Briefing-Clinical practice-Debriefing
Improvement of Clinical Teaching - PSU
• Improvement of bedside teaching – faculty development
• More movement to ambulatory settings• Extension of affiliated hospital• Patients bank• Clinical skill training center• Logbook vs portfolio• How to link PBL to clinical education
Improvement of Clinical Teaching - PSU
• QA – subject audit, not department ?Narrative report Quality improvement – what,
how ?Link O-L-E PDCA
Standard, indicators TQA, WFME model
P D
CA
“The Best is an Enemy of Quality”
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