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Efeective clinical and practical skill teaching
1. Effective teaching of Clinical skills
Dr. Hironmoy Roy
MD, MBA, DHM, FAIMER (2015)
MHPE, MIPHA, MNAMS
2. “ The end of education,
especially
professional education is
Not knowledge
but appropriate action”
3. "Having studied the Science
Having grasped the meaning
Having acquired the skills
Having operated on dummies
And with ability to teach the science,
a Physician should enter the profession”.
4.
5. Skill
" An ability and capacity acquired through
deliberate, systematic and sustained effort
to smoothly and adaptively carry out
complex activities or job functions involving
ideas (cognitive skills), things (technical
skills) and /or people (interpersonal skills).
6. Skill- types
Intellectual skill
To think in a desirable way- underlining
component is knowledge
e.g. - Ability to interpret liver function test
results of a patient with jaundice
8. Skill- types
Communication skill
Ability to communicate with others in a given
situation. Strong underlying component is attitude
e.g. - Ability to motivate relatives for blood donation.
9. Skill- types
Team Skill
Ability to work together in a team
e.g. - Ability to work towards implementing a
project/ operating on a patient with the team.
10. Current trends of teaching “skill”
Master- apprenticeship model
• ‘ See one, do one’- heralds problems
• Knowing and watching a procedure does not mean
one can perform it
• Passive observation rather than active
• participation of learners
13. The “master is the model”, who
directs, demonstrates, comments, inspires
&
The “apprentice is the disciple”, who,
listens, watches, imitates, does and seeks approval
14. Problems in teaching
clinical skill
Lack of clear objectives
Large number of students
Teacher has “no time” (load of patient/practice)
Students are not interested (more to MCQ)
Not explicit in the curriculum/syallabus
Not standardized across schools
Over-burdening with content information
Inadequate supervision and feedback
Little opportunities for reflection and discussion
Clinical teaching not given high priority
15. Then, why to emphasise on learning of skill?
• Growing mistrust among public for medical profession
(cases of negligence, misconduct, and unethical practices)
• Performance emphasis is increasing at all levels of our
professional activity
• Greater public understanding and enhanced patient’s
rights
• Medical school skills education has been slipping down
18. Instructor does & describes
Instructor does, while the
student describes
The student does & describes
(under supervision) ; receives
feedback
The student practice his own
The student does his own
34. Simulation……advantage or disadvantage?
Advantage
• Practice in a safe, protected
• environment
• Decreases risk to patients
• Enables deliberate practice
• Is safe to learn from errors
• Scenarios can be reproduced
• Rarely encountered important
clinical accidents e.g. Anaphylaxis
• Technical as well as non-technical
skills can be practiced
• Skills assessed in objective and
reproducible manner
Disadvantage
• No real life feeling
• Students may not feel
comfortable in real-life settings
• Over-protection makes
handicapped
• Students not get aware of the
real life ‘side-effects’
35. Finally, while to plan the teaching on clinical skills…..
Objective
• What to teach?
Settings
• Whom to teach?
• Where to teach?
• How to teach?
Execute
• Implement
• Feedback