The Balancing Act: Teaching Responsibilities vs. Clinical Productivity
Linda L. Carr, Ph.D. CEO, Faculty Ed Solutions, LLC
Linda L. Carr, Ph.D. CEO, Faculty Ed Solutions, LLC
Know Do
Learning Objectives
How to balance your workload between teaching and clinical responsibilities.
How to involve your staff in preparing for learners.
Encouraged and inspired to involve learners during patient visits and assist them in becoming more self-directed.
Develop specific strategies to increase time efficiency during learner-patient visits.
See Slide Notes Feel
Why is There a Medical Student in my Exam Room? Dr. Michael Nicklawsky | Ingrid Anderson, MSIII Affiliated Community Medical Centers – Willmar, MN Improves overall patient care Students spend more time with patients Patients play a vital role Can lead to high quality medical students Nicklawsky, M. (2013, September 3). Why is There a Medical Student in my Exam Room? [Blog post]. Retrieved from http://discoveracmc.com/why-is-there-a-medical-student-in-my-exam-room/
How do you prepare for learners before they arrive?
Do you meet with staff to plan for students/trainees?
Do you put someone else (e.g., a partner, office manager) in charge of this?
Be ready to welcome them when they arrive!
Balance Patient Care and Teaching after the Learner Arrives by …
Orienting learner to office.
Introducing learner to staff.
Asking nurse or other staff to help manage patient flow.
Selecting patients the learner will see.
PEP2 Facilitator’s Module 9 (Teaching & Learning Collaboratively), p. 9.9.
How to Accommodate Teaching in the Ambulatory Setting
Many preceptors accommodated their teaching by minimally reducing their clinical loads and lengthening their workdays by approximately one hour.
Case presentations / discussions took 4 -15 min. per case (in ambulatory care settings).
Preceptors should expect to spend 10 -15 min./case presentation / discussion with medical students.
Ferenchick et al (1997). Strategies for Efficient and Effective Teaching in the Ambulatory Care Setting. Academic Medicine 72(4), 277-280.
Do these findings surprise you?
No. of Students Time in minutes HPE 5 2.2’ Present to Preceptor 5 7.9’ Observing Preceptor / repeating exam with patient 5 1.8’ Receive direct instruction / feedback from Preceptor 23.7’ TOTAL (11.7’ w/ Preceptor) 33 Patient Encounters w/Students Comparison Study: 33 Patient Encounters with Preceptor only (10.6’ Preceptor time) (1.1’ Difference) Usatine et al (1997). Four Exemplary Preceptors’ Strategies for Efficient Teaching in Managed Care Settings, Academic Medicine 72(9), 766-769.
Time-Efficient Strategies before the Learner-Patient Encounter
① Practice anticipatory precepting (before the student sees a patient) -- adjust to learner’s level.
② Modify your schedule (i.e., wave scheduling).
PEP2 Facilitator’s Module 9 (Teaching & Learning Collaboratively), p. 9.9.
Time-Efficient Strategies
Ask learner to present case in the exam room (except in sensitive situations)
Verify physicalfindings
Combine patient management and education with learner education
How do you involve the learner when you are ready to see the patient?
PEP2 Facilitator’s Module 9 (Teaching & Learning Collaboratively), p. 9.10.
Orient Learner to Patient
Provide 1-minute,patient-specific orientation
Have Trainee Review Patient’s Chart & Purpose of Visit
Tell Student which complaint to focus on Setguidelines for PE Set a time limit for initial encounter Alert learner of any anxietyprovoking conditions
What strategies do you use for time efficiency during student-patient visits?
PEP2 Facilitator’s Module 9 (Teaching & Learning Collaboratively), p.
9.9.
See other patients
Do paper work
Answer phone
Facilitator’s
&
Strategies for Time Efficiency during the Learner-Patient Encounter
calls Preceptors can … PEP2
Module 9 (Teaching
Learning Collaboratively), p. 9.9.
Time-Efficient Strategies after Learner-Patient Visit is Completed
Assist learner in developing a self-directed learning plan.
Help learner use the best evidence to make clinical decisions.
Involve learners in discussing time efficiency and a discussion of medical business.
Cultivate a safe learning environment.
PEP2 Facilitator’s Module 9 (Teaching & Learning Collaboratively), p. 9.11.
What else can learners do to help reduce your workload? Find a resource to aid learning Make patient-related phone calls Check next day’s schedule, read charts
Summary
BEFORE Learner Arrives:
- Involve your staff in planning
- Review clinical rotation goals and objectives
DURING Learner-Patient Visits:
- Practice “anticipatory precepting”—involve the learner
- Orient learner to each patient encounter
- Use “wave” scheduling
- Provide a one-minute patient-specific orientation
- Teach with the patient
AFTER Learner-Patient Visits:
- Assist learner in developing a self-directed learning plan
- Involve learners to help reduce your workload
Implement at least one of the ideas shared about preparing for and working with learners to increase their learning and your efficiency.
LEARN – REFLECT - TEACH
What will you keep the same?
What will you do more of?
What will you do less of?
What will you stop doing?
What will you do differently & how will you do it?
What will you add?
