How to Teach in Clinical Settings

Mary Seabrook, Medical Education Consultant, London, UK

• Acknowledgements ixIntroduction xiChapter 1 Creating an effective learning environment 1Practical ways to create an environment conducive to learning 4Design of clinical placements 6Continuity between learners teachers and patients 8Teaching and learning resources 9The teaching climate 9What makes a good clinical teacher? 10Involving patients in teaching 11Involving other disciplines in teaching 13Some principles of effective clinical teaching 15Useful strategies for clinical teaching 15Five tips for clinical teaching which do not take time or money 17References 17Chapter 2 Teaching in clinical contexts 19Teaching on ward rounds 19General principles 19Useful strategies 21What you teach unwittingly 23The psychiatric ward round 25Handover meetings board rounds and bench rounds 26Bedside teaching 29Preparation 29Structure for bedside teaching 30Feedback at the bedside 34Examination practice at the bedside 36Teaching in clinics 38General principles 38Supervising trainees in parallel clinics 40Effective questioning on presented cases 41Seeing the patient together 42Supervising students or trainees who are supernumerary 43Teaching in the Accident and Emergency department 46Teaching the interpretation of images/specimens 47Teaching in theatre 49General principles 50Useful strategies 50Teaching practical skills 56On-call/remote teaching 60Teaching patients 62Teaching other disciplines 64Further reading on clinical teaching 65References 66Chapter 3 Workplace-based assessment and feedback 67The workplace-based assessments/supervised learning events 67Using the tools effectively 69Case-based discussion 71The mini-clinical evaluation exercise (Mini-ACE in psychiatry) 73Directly observed procedural skills 75Multi-source feedback (MSF) 77Teaching observation tools 79Giving feedback 81Giving negative feedback 81General principles of feedback 82Useful strategies for giving feedback 82Feedback models and structures 85Further reading on assessment and feedback 89References 90Chapter 4 Common problems in clinical teaching 91Balancing teaching and service demands 91Pitching teaching at the right level  94Dealing with complaints and clinical incidents 96Ad hoc teaching 100Teaching people at different levels together 101Teaching older or more experienced colleagues 103Engaging the quiet or reluctant learner 104The difficult consultation 106Teaching multiple students 107Teaching trainees with no interest in your speciality 108References 109Chapter 5 Next steps 110Developing as a teacher 110Evaluating your teaching 111Useful resources 115Appendix Glossary of assessment tools 118Index 119