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Clinical teaching

Overview:

Clinical teaching takes places particularly at HEALTH and is essential to ensure that students build the competences and skills they will need as health professionals. The teaching activities, learning environment and shared understanding are important for successful clinical teaching. Both hands-on experience and time for reflection and feedback are required, and it must be taken into consideration that the realities in the clinic may be overwhelming for students.

 

Learning options in clinical practice

Some degree programmes, particularly at HEALTH, imply periods of clinical practice outside of the university. This provides the students with opportunities to experience and learn indispensable professional skills. Seeing and experiencing an operating room, meeting real patients, speaking to the parents of a sick child or being part of a healthcare team may be inspiring and may also affect the students’ choice of career.

The organisations that provide clinical teaching are in charge of facilitating learning opportunities in a structured, secure and balanced manner. The students will learn about the health sector and develop professional competences such as clinical decision-making; they will develop professional skills such as objective examination, communication, patient management and professional socialisation, i.e. acting and behaving like a (health) professional. At the same time, the organisation of a workplace is complex and sometimes unpredictable, which is also part of the experience.

Student expectations and development potential

Students have high expectations – and are often nervous when embarking on clinical teaching. Knowledge of how to act as a health professional can only be acquired through hands-on experience and time for reflection and feedback. Clinical teaching may be overwhelming; the pace in the workplace may be extremely demanding, and patients and their relatives are often accustomed to experienced health professionals and therefore also make demands on the student.

Clinical teaching trains a number of skills which the students must acquire to become professionals:

  • Documenting: collecting anamnesis, using electronic patient records, using local guidelines
  • Procedure skills: objective examination, health promotion, clinical decision-making, diagnosing and contributing to good patient management
  • Communicating and collaborating
  • Time management and organisation
  • Health and safety rules
  • Administration, documentation and management
  • Technical and instrumental skills

It is also important to recognise human skills in this context, such as situational awareness, empathy, team communication, stress and observational skills. As a teacher, you should consider how to address the development of these aspects and how to provide feedback on them.

Structured approach to the teaching of clinical skills

As a teacher, you may structure the teaching of clinical skills in the following three phases:

  • The cognitive phase: Training in routine tasks under supervision by experienced health professionals
  • The associative phase: organised training to integrate partial skills
  • The autonomous phase based on the acquired skill

The so-called STEPS model may be used to structure the teaching:

S - Set the foundation of prior learning, the importance of the skill and context of usage.

T - Tutor demonstration without commentary

E - Explain with repeated demonstration

P - Practice under supervision with feedback from peer and tutor

S - Subsequent deliberate practice is encouraged.

 

Teachers should ask themselves the following questions:

  • What are the expectations and skills of the student?
  • How can I plan structured learning opportunities?

  • What tasks, such as routine tasks, can the student be given responsibility for?

  • How can I give feedback and acknowledge the student’s contribution and participation?

  • How do I communicate with and include the student?

 

Activities

Under development

    Examples of practice

    Under development

      Further reading

      • AMEE Guide no. 34: Teaching in the clinical environment
      • Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–81.
      • R. Gagne. The Conditioning of Learning and Theory of Instruction (4th ed.), Holt-Saunders International editions, New York (1985)
      • McLeod, Peter J., et al. "The ABCs of pedagogy for clinical teachers." Medical Education 37.7 (2003): 638-644.
      • Lave, Jean, and Etienne Wenger. Situated learning: Legitimate peripheral participation. Cambridge university press, 1991.

      Contact:

      Health

      The content of this page was prepared on the basis of contributions by Mads Ronald Dahl in Introduction to Teaching and Learning.