Taking Advantage of the Teachable Moment: A Review of Learner-Centered Clinical Teaching Models

Abstract

When working in a chaotic Emergency Department (ED) with competing priorities, clinical teaching may be sacrificed for the sake of patient flow and throughput. An organized, efficient approach to clinical teaching helps focus teaching on what the learner needs at that moment, incorporates regular feedback, keeps the department on track, and prevents over-teaching. Effective clinical teaching in a busy environment is an important skill for senior residents and faculty to develop. This review will provide a critique and comparison of seven structured teaching models to better prepare readers to seize the teachable moment.

Strategies for improving clinical teaching in the emergency department: Applicable to clinical teachers and especially emergency medicine

“…When the steps are usually well performed, the rest of the strategies can become implemented easily. The next phase frames each specific teaching encounter involving the setup (S), a particular teaching point or rule (T), assessment and provision of positive constructive feedback (A), and role model through demonstration and clinical practice, the realization of each one is always the teacher (T) (16).…”

“…The skill sets that make up the model are (1) asking for commitment, (2) probing for underlying reasoning, (3) teaching involving general rules, (4) supporting which was done or offering positive feedback, and (5) correcting mistakes. The model can be utilized as a set framework with the most clinical teaching encounters (6,16,17).…”

“…At the core of SNAPPS, there is actually a shift in paradigm in which the preceptor no longer plays the key role. The SNAPPS, similar to the One-Minute Preceptor, is a mnemonic for Summarizing the patient's history and findings, Narrowing the differential to two or three relevant possibilities, Analyzing the differential by comparing and contrasting the possibilities, Probing the preceptor by asking questions about uncertainties or alternative approaches, Planning management for the patient's status, and Selecting a new caserelated issue for self-directed learning (6,16).…”

“…Clinical teaching at the ED requires balancing the provision of patient care services, clinical teaching, and clinical experiences for learners at different levels of learning. Therefore, clinical educators should recognize the gap between clinical teaching, needs assessment of learners, and clinical environment and provide feedback for learners (1,2). They should provide practical education with regard to learner's needs and training, take into account these needs, and provide feedback for learners' performance.…”

“…Because the role of teachable moments is very important for learners and clinical educators in the busy educational environment; consequently, using effective teaching strategies in clinical teaching at equally teachable moments and getting feedback from learners provide a balance between patient care and education (2). Considering the importance of the ED in teaching essential skills and sensitivity in the provision of care services for patients, this study aimed to review the strategies for improving clinical teaching in the ED.…”