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An overview of the process of clinical debrief
Citation preview
Clinical debriefingClinical debriefingKurt WilsonKurt Wilson
Intended learning outcomes
Use clinical debriefing to deliver teaching, learning and assessment
Enhance reflective practice
Gain greater two-way feedback through clinical debriefing
Clinical debrief sessions: Aims and Clinical debrief sessions: Aims and objectivesobjectives
Students will use debrief sessions to:Students will use debrief sessions to:– Learn through their own and each other’s clinical experienceLearn through their own and each other’s clinical experience
– Develop presentation, communication, examination and Develop presentation, communication, examination and therapeutic skillstherapeutic skills
– Practice record keepingPractice record keeping
– Discuss ethical issuesDiscuss ethical issues
– Prepare for future undergraduate assessmentPrepare for future undergraduate assessment
Where does it happen at the moment?
What is meant by “clinical debriefing”
Case presentation
History Examination Investigations
Margin hypothesis Best test?Examination first
Debate and discussion
Tutor led Student led
Intended learning outcomes
Who helps them understand what is happening in clinical environments?
How well are they able to help each other understand wider issues from clinical experience?
‘Miseducation’
Generic techniques
Case presentation
History Examination Investigations
Margin hypothesis Best test?Examination first
79 yr old male
Chest pain
On examination:
Sat up in bed
Oxyhen via
nasalCannulaGeneral: Pale,
Resting tremor
Margin hypothesis generation
Differential diagnosis Generation
Ranking
Discussion
Generic techniques
Case presentation
History Examination Investigations
Margin hypothesis Best test?Examination first
79 yr old male
Chest pain
Sat up in bed on
Cardiac unit
Oxygen via
nasalCannulaGeneral: Looked
Pale, tremor
noted
Examination findings first
Understand importance of patient history
Few clues from examination?
List of diagnoses and uncertainties large?
Best test?
Case presentation
History Examination Investigations
Margin hypothesis Best test?Examination first
Best test?
Only allowed one testWhich one and why?
Specificity (false positives?)
Sensitivity (false negatives?)
Positive and negative predictive values
Subsequent sessionsSubsequent sessionsContinue to address history taking/presentation/group Continue to address history taking/presentation/group interaction and case discussioninteraction and case discussion– Ideas, concerns, expectationsIdeas, concerns, expectations– Margin hypothesis generationMargin hypothesis generation– Examination findings firstExamination findings first– Best test?Best test?
– Sensitivity and specificitySensitivity and specificity
Structure sessionsStructure sessions
Topics for discussion
Issues surrounding patient centred care
Treating individuals versus population medicine
Disclosure, recommendation and understanding
What might students get out of it?
… very useful to learnfrom fellow students…
…very good as interactive and varied…
…topic discussion was particularly
useful as the group were able to address learning objectives not raised
in PBL
…feedback was constructiveand very encouraging… …I felt like I was applying my
knowledge & this simulates what will happen later in ‘real life’
Finally…
Tutor perspectives:– Support learning, including learning from
negative experience and correction of misconceptions
– An objective view of events, an appreciation of different perspectives and view points
– Stimulation of deeper and more complete learning
http://www.slideshare.net/wilsonkurt
Finally…
Things going well for new tutorsThings going well for new tutors– Margin hypothesisMargin hypothesis– Opportunity to learn outside of current PBL agendaOpportunity to learn outside of current PBL agenda– Roleplay and discussionRoleplay and discussion– EthicsEthics– Teaching and learning experiencesTeaching and learning experiences
Thinks not working well for new tutorsThinks not working well for new tutors– Getting the students to actually see patients!Getting the students to actually see patients!– Getting students to examine patients, even with prior Getting students to examine patients, even with prior
instruction from the tutorsinstruction from the tutors