Not that long ago, I remember being thrust into the role of a senior resident on wards and being responsible for the educational experience of medical students. I was still trying to figure out how to manage patients - how was I going teach the medical students? How could I be supportive of their learning? It was overwhelming and I remember wishing someone would provide me with additional guidance.
Years later, after finishing a Masters in Medical Education, I gained some tools that allowed me to understand how being a good teacher was an art and a learned skill – not something that comes innately. I wanted to impart some of the skills I had learned to the senior residents in our program so they did not feel as lost as I did all those years ago. Furthermore, residents at our program had expressed a need for guidance in teaching medical students. Thus, I challenged myself to start a curriculum for internal medicine residents focusing on the “One Minute Preceptor” – an educational technique that could be useful for them when teaching on the words.
“One Minute Preceptor or “Five Micro-Skills” is a great educational technique! It is an easy, efficient technique that incorporates many of the important components of adult learning theory, such as knowledge assessment, clinical reasoning and feedback. Moreover, many teachers use various steps already without realizing their technique. This could be a perfect tool for busy residents with a heavy clinical load and increasing teaching responsibilities, and this prompted us to start a monthly curriculum at our academic center for internal medicine residents. In fact, a systematic review of Resident as Teacher curricula found that “One Minute Preceptor” is one of the most frequently used in Resident as Teacher curricula across the country. Additionally, the technique has been shown to improve student ratings of residents.
We started a 30-minute workshop with our internal medicine residents focusing on the “One Minute Preceptor” steps – Get a commitment, Probe for evidence, Teach a general rule, Reinforce what was done correctly, and Correct mistakes. In planning the curriculum, important considerations in our discussion included length of the workshop and where it could be easily incorporated into busy resident schedules. We also planned the curricular evaluation so it could be improved over the course of the year.
The workshop goals include having residents learn about the steps and then practice the technique using a think-pair-share activity during the 30 minutes. We begin the workshop by discussing the challenges of teaching on general medicine wards, and during this discussion the residents are very engaged and are insightful in their comments. Some of the challenges that are frequently brought up include limited time with heavy clinical load, teaching to various levels of learners, teaching to an advanced learner and confidence in their teaching abilities. The discussion allows them to share, but also more importantly, allows us to get the audience buy-in.
After discussing challenges, we clarify the technique with an interactive workshop. One of the keys to making this a productive, interactive session is using real-world examples as medical cases to teach the technique. We begin with a complicated MICU transfer with multiple medical problems, and the residents recognize the complexity of teaching in that case. Using this real world case, the residents go through a role-play to understand each step of the “One Minute Preceptor.” The importance and purpose of each step is highlighted by the speakers. For practicing the technique, the residents pick a current patient on their list for the think-pair-share activity and see the real world application of the technique during this workshop. We end with a discussion of how “One Minute Preceptor” will help overcome some of the challenges that were discussed in the beginning, and the real world application really highlights for them how “One Minute Preceptor” can be helpful.
Overall, the workshop feedback has been positive! Residents recommend the workshop to their peers and indicate that they are “likely” or “very likely” to use “One Minute Preceptor” to teach medical students and residents. As I developed the curriculum, there are a few important lessons that I have learned. First, it is important to gain buy-in from your audience – in our case, the discussion about challenges to teaching on wards is instrumental in getting the residents to understand that these challenges are normal, and we are going to discuss some solutions during the workshop. Second, using pertinent case based education is important in having the audience understand the application of the curriculum. The concept of using relevant cases in curricula is well grounded in adult learning theory, which states that adults want to understand the application of their learning rather than just memorize facts. These lessons will guide me in any future curriculum development projects I pursue.
Did you know that the Harvard Macy Institute Community Blog has had more than 210 posts? Previous blog posts have explored topics including using instructional design support to leverage your teaching, implementing collaborative learning methods, and interprofessional education.
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