QHPE 601 Experiential Learning Teaching Methods PDF

Experiential Learning Teaching Methods QHPE 601 Evidence-based Teaching and Learning Faculty Credits The following faculty are attributed to the slides and ideas of this session (in alphabetical order) Dr Ahsan Sethi Dr Daniel Rainkie 2 Learning...

Experiential Learning Teaching Methods QHPE 601 Evidence-based Teaching and Learning Faculty Credits The following faculty are attributed to the slides and ideas of this session (in alphabetical order) Dr Ahsan Sethi Dr Daniel Rainkie 2 Learning Objectives By the end of this session the learner will be able to: Describe approaches to teaching in the workplace Script formation (setting of clinical reasoning) One-Minute Preceptor SNAPPS 3  Scripts Illness scripts, management scripts 4 Scripts: Development from S2 to S1 Thinking Scripts are a framework for how we chunk information together and think through problems High level, precompiled, conceptual knowledge structures Are NOT algorithms Activated by specific problem (e.g. diagnosis, presenting signs and symptoms) Scripts… Provide structured knowledge necessary for understanding behavioral sequences Enable individuals to integrate new information with existing knowledge Guide memory retrieval Enable predictions about what will happen in the near future Guide actual behaviour when activated in specific contexts Contain knowledge that can usually be applied to explain why a specific action or sequence of actions has occurred or might occur 5 Clinical Reasoning 6 Example of Script Development 7 Example script template Each component is a ‘slot’ in the script that is to be filled 8 Example of Comparison of the Management Scripts 9 Teaching to Develop S1 (scripts) and S2 (analytical) 10 Threats of Expertise and Mastery Decision making for the majority of clinical cases encountered are automatic Automatic decision making = complacency = strong resistance to change 11 One-Minute Preceptor 12 One minute preceptor Five micro-skills to guide preceptor-student encounter 1. Focus on a single learning point Focus on 1 learning point Encourage critical thinking and clinical reasoning skills Establish level of competence Push comfort zone (zone of proximal development) 2. Probe for supporting evidence Ask “why” (in a non-accusatory way!) “Can you explain how the heart works in the setting of heart failure?” “What other factors support your diagnosis?” “Why wouldn’t we use a different treatment option?” 3. Reinforce what was done well Positive reinforcement (behaviourism) on skills done well 4. Give guidance about errors or omissions Provide timely, objective feedback Limit formative feedback for improvement actions to avoid overwhelming student 5. Teach a general principle Share your experiences of reasoning 13 One-Minute Preceptor Evidence Studied in multiple contexts, various levels of expertise, in different healthcare professions A moderate quality systematic review capturing studies until Feb 2018 identified 12 quantitative studies citing OMP model is preferred by students and preceptors to standard care for clinical teaching Increases the use of teaching techniques including Assessing and developing students’ clinical reasoning Providing effective feedback 14 SNAPPS 15 SNAPPS: A Six-Step Learner-Centered Approach 16 SNAPPS Evidence A BEME realist systematic review found 7 studies of SNAPPS compared to usual teaching resulted in Increased number of differential diagnoses (2.08 vs 0.81 items) Increased justification to support differential diagnoses (1.26 vs 0.22 items) Discuss patient management (85% vs 54%) Engage in self-regulated learning activities Asking questions or describing uncertainties (84% vs 11%) Initial reading selections for self-study (52% vs 0%) A systematic review of methods to improve diagnostic reasoning found 2 studies which both found that the SNAPPS model improves diagnostic reasoning Increased number of differential diagnosis Increased features to support the differential diagnosis 17 SNAPPS vs One-Minute Preceptor Design Randomized, single centered, parallel, active-controlled study Population 5th year medical students (Brazil) recruited during their first clerkship (12 week pediatrics block) (n=60) Avg participant: 53% male, 24 years old Intervention SNAPPS Introduction session (n=30) Students presented and discussed 2 cases (1 simple, 1 complex) Case presentations recorded and evaluated by 2 researchers Comparison One-minute (n=30) preceptor Outcomes Expression of clinical reasoning: SNAPPS = OMP Reasoning questions and uncertainties: SNAPPS > OMP (p OMP (p