teaching clinical skills -guideline preparation- zekeriya aktürk, prof. dr. 21 january 2013...

Teaching Clinical SkillsTeaching Clinical Skills

-guideline preparation--guideline preparation-

Zekeriya Aktürk, Prof. Dr.

21 January 2013zekeriya.akturk@gmail.com

http://aile.atauni.edu.tr

Student Assessment CourseUniversity of Science and Technology

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Objectives

• By the end of this module you should be able to;– Discuss the importance of skills training in medical

education

– Discuss the relation of coaching to skills training

– Describe a method for coaching

– Describe guidelines and their importance in coaching

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• ‘Observe, record, tabulate, communicate. Use your five senses… Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert’   

Sir William Osler (1849–1919)/ 213

What teaching methods to use?

• See one, do one, teach one

• Skills teaching on manikins

• Skills teaching on simulated patients

• Skills teaching on real patients

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Selecting the Best Method

Knowl Attitude Problem s. Commun. Skills

Classroom teach 7 3 4 2 0

Discussion 8 9 6 7 2

Audiovisual lect 6 3 4 1 4

Simulation 4 8 8 8 3

Case studies 5 7 9 3 4

COACHING 5 6 8 7 9

Demonstration 6 4 7 4 9

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Sousa, D. A. How the brain learns: A classroom teacher's guide. 2nd ed. Thousand Oaks. Corwin Press: CA USA; 2001. p. 95

Why Skills Teaching?

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COACH Approach

• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

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COACH• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

What kind of role model?

• Expert

• Allows observation

• Standards of practice are clear/ 218

COACH

• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

• Motivating/positive

• Secure

• Pyschologic and social support

• External resources enough

What kind of learning env.?

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COACH

• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

• Contiuous, esp. formative

• Measuring target outcomes

• Feedback

• Clear competency level

What kind of assessment?

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COACH

• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

• Intended to understand

• Effective listening

• Empathy

• Asking questions

What kind of communication?

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COACH

• Clear performance

• Openness to learn

• Assess performance

• Communication

• Help and follow-up

• For complete learning

• During education

• After education

• Plan-apply-follow up

What kind of help?/ 2112

Five-Steps Approach

1. Overview

2. Demonstration

3. Describe each step

4. Students talk through the skill

5. The students perform the skill

John H. George, Frank X. Doto, Fam Med 2001;33(8):577-8

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Examples of Clinical Skills Guidelines

and OSCE Steps

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http://www.scionpublishing.com/shop/ProductImages/OSCES%20Mock%20Marking%20Scheme.pdf

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https://www.fammed.wisc.edu/sites/default/files//webfm-uploads/documents/med-student/pcc/practice-osce-scenarios.pdf

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How do you assess the learning of these skills?

• ‘Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer’– The long case– The short case– Objective structured clinical examination (OSCE)

– Workplace-based assessment

Charles Caleb Colton (1780–1832)/ 2120

Summary

• What is the best method of teaching psychomotor skills?

• What are the steps in teaching clinical skills?

• How would you develop steps for clinical skills guidelines?

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