Making the Most of Five Minutes: The Clinical Teaching Moment

Abstract

Clinical educators face the challenge of simultaneously caring for patients and teaching learners, often with an unpredictable caseload and learners of varied abilities. They also often have little control over the organization of their time. Effective clinical teaching must encourage student participation, problem solving, integration of basic and clinical knowledge, and deliberate practice. Close supervision and timely feedback are also essential. Just as one develops an effective lecture through training and practice, clinical teaching effectiveness may also be improved by using specific skills to teach in small increments. The purpose of this paper is to identify potential teachable moments and to describe efficient instructional methods to use in the clinical setting under time constraints. These techniques include asking better questions, performing focused observations, thinking aloud, and modeling reflection. Different frameworks for teaching encounters during case presentations can be selected according to learner ability and available time. These methods include modeling and deconstructing the concrete experience; guiding the thinking and reflecting process; and providing the setting and opportunity for active practice. Use of these educational strategies encourages the learner to acquire knowledge, clinical reasoning, and technical skills, and also values, attitudes, and professional judgment.

“They cared about us students:” learning from exemplar clinical teaching environments

“…by enhancing access to learning opportunities, teaching staff, chances to learn from a multidisciplinary team [35] and for ‘teachable moments’ to be used as a way to optimise teaching in a time-poor or unpredictable environment [35]. Pratt, et al [36] specifically recommend such an approach to teaching; that a focus on teaching and learning should extend beyond the singular use of one attending physician or preceptor, and argue that student learning should be a product of the broader context of learning: the “cultural arena within which engagement is invited and supported, or denied.” (p. 136, see also [37]). Interestingly, data we describe under this theme had a comparative lack of student data.…”

‘I’m too busy to teach’. Tips for teaching when time is tight

“…Medical students and trainees can also take the lead using it as a platform to teach and to solidify their learning. It encourages learner participation, problem-solving, and allows integration of basic and clinical knowledge 9. Questions arising from the handover or throughout the day can be addressed during the 5 min on the same or next day.…”

“…For novice learners, observing how experienced clinicians assess, make decisions and communicate with patients and families is a valuable learning opportunity. Role-modelling helps demonstrate important professional skills and behaviours that learners will incorporate when forming their own professional identity 9. It is an effective tool to use where teaching time is limited, in complex cases or with particularly unwell patients.…”