Medical Education & Simulation

  • Terry Prachett (Disc World Author, UK):

It would seem that you have no useful skill or talent whatsoever,” he said. “Have you thought of going into teaching?

  • Albert Einstein (E=MC2):

I never teach my pupils, I only attempt to provide the conditions in which they can learn

EDUCATION

BASIC THEORY

A Brief Summary of Medical Education Basic Theory:  MEDICAL EDUCATION

SIMULATION

Our Latest Review on Simulation in Healthcare: SIMULATION IN HEALTHCARE

  • Our Free Simulation Resources:
    • Blood Gases
      • A Simple Tool – The Blood Gas Generator
        • Use this blood gas powerpoint – change the numbers and ‘save as’ JPEG then print for a high fidelity blood gas
    • Templates
    • Results
    • Stress Inoculator
      • Make your Students/Nurses/Doctors run up and down before entering the room when responding to a call for help in Simulation.  Also ask them to go in the Sim Room one at a time.  These simple actions add to Psychological fidelity and often adds to the debriefing discussion of the importance of “Handover”

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THE CLINICAL TEACHER

The Excellent Clinical Teacher

What competencies should he or she have?

The excellent teacher should be an information provider, role model, facilitator, assessor, planner and resource developer (AMEE).*   In the past education has been valued highly, but the teaching of medicine is prone to prejudice, hunches, opinion and guesswork.  A modern approach to teaching should take a focus on scientific basis (best evidence) and ethical values.  There should also be careful consideration of the clinician’s rationale for descion making as well as a focus on the ‘team factors’ that influence the patient’s management (including an awareness of ‘human factors’).

MEDICAL EDUCATOR ROLES HARDEN 2002

The picture painted above relates to an idealistic model of the modern medical teacher.  In addition to working on some of these areas to improve our own teaching skills, we need to also remember the importance of feedback to the adult learner.

Timely and appropriate feedback is an essential step but takes practice to give and receive.

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Principles of Good Teaching in the ED

  • Plan ahead
  • Manage Time
  • Set aside time for teaching
  • Know your Learners and Set Goals
  • Choose the Right Time (for example not after a shocking resuscitation or when the department is dangerously busy)
  • Set Expectations of the Students
  • Use Summaries for the Student’s benefit
  • Understand Basic Educational Theory (see above and Kolb’s Cycle below)
  • Understand Different Learning Styles (your students have different styles and may be different to you)

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Kolb’s Theory

DAVID KOLB - Theory of Experiential Learning

Kolb – Different Learning Styles

What is your Learning Style? – Take the Test now

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EDUCATIONAL TECHNIQUES IN THE EMERGENCY DEPARTMENT

What Teaching Models can be used in the busy ED?

Various examples of  effective teaching can be used – even when time is limited…

Identify the learners’ needs by gathering information:

  • Ask Questions (in a non threatening and open manner)
  • Observation – with feedback
  • Consider the best educational tools for delivery of your learning objectives – CLICK HERE

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4 Suggested Models of Teaching for the Busy ED

  • The 1 minute Preceptor
  • Aunt Minnie
  • S.N.A.P.P.S.
  • Bedside Presentations

(1) The 1 Minute Preceptor Model

– The popular one minute preceptor model attempts to identify learning needs rapidly by getting a commitment from the learner (for example a differential diagnosis for the patient they have just discussed with your).  This is followed by understanding what grounds the learner has to base their answer on and using this as a basis of teaching a few key principles.  This model’s main problem is it usually takes 2 – 5 minutes to complete.
We find the summary HERE very useful.
Overview of this Model:
  1. Get a commitment

  2. Probe for supporting evidence

  3. Teach general rules

  4. Reinforce what is right

  5. Correct any mistakes

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(2) Aunt Minnie Model

  • Imagine your have just seen a ‘Classic Case’! Straight from the Textbook Signs and Symptoms…
  • The simple “Aunt Minnie” model is based on Rapid Pattern Recognition
  • ‘It walks, talks and looks like a duck – it’s probably a duck’
  • For example in the ED there might be a patient with a classic X-ray, clinical sign or ECG finding that can be shared with the students or junior doctors

A Summary is found by CLICKING HERE

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(3) The SNAPPS Model

  • Summarise (S)

  • Narrow Down (N)

  • Analyse (A)

  • Probe (P)

  • Plan  (P)

  • Select (S)

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(4) The Bedside Presentation with Feedback (e.g. MiniCEX or DOPS)

  • Can be used in a variety of circumstances

  • Preferably after student or junior doctor has finished their assessment of the patient

  • Try to involve the patient in the process to facilitate learning

  • May be combined with traditional bedside teaching methods

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Summary of Good Teaching Habits for Critical Care or Emergency Department Setting 

  • Give information in Short ‘snippets’ and consider using one of the above models for delivery

  • Feedback is Crucial in Adult Learning

  • Be Positive and Focus on Improvement

  • Discuss Specific Behaviours

  • Brief Clear and Concise

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