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How to Teach in Clinical Settings



How to Teach in Clinical Settings

Mary Seabrook

ISBN: 978-1-118-62092-2 November 2013 136 Pages

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How to Teach in Clinical Settings is a practical guide to support all doctors wishing to develop their skills in clinical teaching and supervision.

It provides hands on strategies to address common problems such as giving critical feedback effectively and teaching mixed-level groups. It gives guidance on the particular challenges of teaching in clinical settings including the need to manage teaching with service provision, to engage patients, motivate students, and to judge the balance of support and independence appropriate for each trainee.

How to Teach in Clinical Settings is invaluable for all doctors involved in teaching and training at any stage of their career. It is also useful and accessible to medical students who increasingly need to consider and develop their own teaching skills as part of their career progression.

Acknowledgements ix

Introduction xi

Chapter 1 Creating an effective learning environment 1

Practical ways to create an environment conducive to learning 4

Design of clinical placements 6

Continuity between learners teachers and patients 8

Teaching and learning resources 9

The teaching climate 9

What makes a good clinical teacher? 10

Involving patients in teaching 11

Involving other disciplines in teaching 13

Some principles of effective clinical teaching 15

Useful strategies for clinical teaching 15

Five tips for clinical teaching which do not take time or money 17

References 17

Chapter 2 Teaching in clinical contexts 19

Teaching on ward rounds 19

General principles 19

Useful strategies 21

What you teach unwittingly 23

The psychiatric ward round 25

Handover meetings board rounds and bench rounds 26

Bedside teaching 29

Preparation 29

Structure for bedside teaching 30

Feedback at the bedside 34

Examination practice at the bedside 36

Teaching in clinics 38

General principles 38

Supervising trainees in parallel clinics 40

Effective questioning on presented cases 41

Seeing the patient together 42

Supervising students or trainees who are supernumerary 43

Teaching in the Accident and Emergency department 46

Teaching the interpretation of images/specimens 47

Teaching in theatre 49

General principles 50

Useful strategies 50

Teaching practical skills 56

On-call/remote teaching 60

Teaching patients 62

Teaching other disciplines 64

Further reading on clinical teaching 65

References 66

Chapter 3 Workplace-based assessment and feedback 67

The workplace-based assessments/supervised learning events 67

Using the tools effectively 69

Case-based discussion 71

The mini-clinical evaluation exercise (Mini-ACE in psychiatry) 73

Directly observed procedural skills 75

Multi-source feedback (MSF) 77

Teaching observation tools 79

Giving feedback 81

Giving negative feedback 81

General principles of feedback 82

Useful strategies for giving feedback 82

Feedback models and structures 85

Further reading on assessment and feedback 89

References 90

Chapter 4 Common problems in clinical teaching 91

Balancing teaching and service demands 91

Pitching teaching at the right level  94

Dealing with complaints and clinical incidents 96

Ad hoc teaching 100

Teaching people at different levels together 101

Teaching older or more experienced colleagues 103

Engaging the quiet or reluctant learner 104

The difficult consultation 106

Teaching multiple students 107

Teaching trainees with no interest in your speciality 108

References 109

Chapter 5 Next steps 110

Developing as a teacher 110

Evaluating your teaching 111

Useful resources 115

Appendix Glossary of assessment tools 118

Index 119