shadow_tr

Guide for Community Preceptors


How to Prepare for Teaching in your Office

Ready! Set! Teach!
For a brief overview of the general steps in clinical teaching model, see the PPT slide program, Ready! Set! Teach!   This program includes information on adult learning, the characteristics of a highly effective preceptor, preparation for teaching in the office and using the “One-Minute-Preceptor” model. 

Getting ready for a student in your office --

  1. The clerkship coordinator at Tulane will contact you regarding: 

    The school's requirements for students during the clerkship:

    • How much time will the student need to spend away from your office for the clerkship curriculum?
    • What activities besides clinical duties will the student engage in while at your office (e.g., giving presentations, note keeping, tracking patients)?
    • What are the clerkship requirements for the student?
    • The clerkship coordinator will provide you with a packet of information. You are also welcome to access all information on this website.

    Tulane's requirements for preceptors.

    • Becoming adjunct faculty
    • How much time must you spend with the student?
    • What kind of reports & timelines are involved and to whom do you report?
    • How do you assess student performance?
  2. Make any needed logistic arrangements. 
    • Discuss the process with your office staff to be sure they are prepared & willing to cooperate.
    • Review the information about your student & decide how you will integrate the student into your practice.
    • Decide where and under what conditions the student will see patients alone.
    • Who will teach/monitor the student if you have to be out of the office during the clerkship period?
    • Explain the teaching process & requirements to your staff.
    • Let your patients know that a medical student will be working with you.
    • Obtain each patient’s permission to have the student in the room/or to be seen by the student independently.
    • When the student is shadowing, be sure to introduce the student as a “physician in training.”

Getting the learner started --

  1. Set a time to meet with the student on the first day and spend a little time getting to know him/her and assessing the level of preparedness, and how best to teach this student.
  2. Acquaint the student with your office procedures & rules. Let the student know when to arrive, when and where he/she can put personal things, work on a computer, spend time reading charts, studying, or completing other required academic tasks. Clearly state your expectations. Note times that the student will need to be out of the office for didactics/exams/community involvement.
  3. Set an academic & professional tone to the process by going over the clerkship’s learning objectives in relation to your specific practice, and discussing the student’s personal goals for the rotation.  The more clarity you can achieve about the process, the more effective the outcomes are likely to be.
  4. During the first week, pay special attention to the student to encourage & stabilize her/his performance, and to evaluate how much independence you can give, and the specific areas of skill that you wish to focus on helping the student to develop. Reassure the student that you will partner with her/him to produce effective skill development.  Treating the student as a novice colleague will facilitate the student’s comfort level as a learner and increase the likelihood of a successful experience for both of you.


Elements of effective clinical teaching:

  1. Engage the student in the process—stimulate interest & ownership
  2. Be clear in your expectations
  3. Gradually increase the student’s independence
  4. Keep the lessons simple & brief
  5. Encourage the student to think on her own & explain her reasoning to you
  6. Model effective & sensitive patient care
  7. Describe your thought process aloud to the student
  8. Allow opportunity for the student to practice what you have modeled
  9. Reinforce the student’s efforts & tactfully make any needed corrections
  10. Provide as much variety of experience as possible

The “One-Minute-Preceptor” model
Clinical teaching is time-limited.  You will be modeling how to think on your feet in a busy practice or hospital, how to assess the basic facts, weigh the most likely options based on your knowledge & expertise, and quickly establish a reasonable diagnosis and treatment plan.  The student will be learning as he watches you and tries to practice what he observes.  To facilitate his learning:

  1. Ask the student what he thinks the patient’s main problem is & what causes he suspects
  2. Check to see what evidence he can supply
  3. Reinforce his efforts & accuracies, and gently redirect errors in reasoning
  4. Briefly mention a relevant general principle that applies in this and similar cases
  5. Check to see if the student needs additional information (if he does, refer him to resources)
  6. End with a concluding statement, and move on to the next patient or task.

Suggested Readings

  • Teaching Skills for Community Based Preceptors
    6 Chapters: What is an effective clinical teacher?; How do we learn? Preparing to Teach.; Teaching with patients. Observation, feedback & assessment; What to do with problem learners.
  • The Clinician-Educator’s Handbook
    20 chapter book addresses a wide variety of issues of clinical education. Designed so that most chapters can be read free-standing and can be used as a reference when looking for specific information.  The authors have divided general teaching techniques (such as establishing goals and objectives, setting curriculum, and asking questions) into their own chapters, distinct from setting-specific chapters.
  • Krane NK, Lazarus CJ, Chauvin SW. A longitudinal community-based ambulatory curriculum utilizing community preceptor/resident/student teams. Acad Med. 2000; 75:535-536.

Modules/Tools

  • Ready! Set! Teach!
    For a brief overview of the general steps in clinical teaching, see the PPT slide program,  Ready! Set! Teach!   This program includes information on adult learning, the characteristics of a highly effective preceptor, preparation for teaching in the office and using the “One-Minute-Preceptor” model.
  • Simple Precepting Tools
    How to Orient Learners to the Practice Setting Guide; One Minute Preceptor; Constructive Feedback; Introducing Learners to Patients Tips; Two-Minute Teaching; Technique for Observing the Learner; Five-Step Method for Teaching Clinical Skills; Priming Learner for Patient Encounter
  • EPIC- The Expert Preceptor Interactive Curriculum
    10 Modules: Setting the Stage; Effective Teaching in the Community Practice; Evaluating Performance and Giving Feedback; Teamwork in Health Care; Information Technology; Evidence Based Care; Clinical-Patient Relationships; Changing Environment: Managing Care; Health Promotion/Disease Prevention; Working with the Community
  • Models for Teaching in the Ambulatory Setting
    Tool for training community preceptors to use a variety of strategies in supervising medical students in the ambulatory setting using a learner-centered approach.
  • Approach to Teaching Clinical Skills: Physical Exam
    44 slide presentation: systematic teaching skills; vocabulary; teaching complex skills; iterative teaching approach; methods and techniques of teaching
  • The Effective Preceptor
    Checklists for 1) Orientation; 2) Teaching; 3) Feedback.
  • "Efficiency through Effective Communication”movie_file
    American College of Physicians -- 20 minute video on effective doctor/patient communication.

1430 Tulane Ave, New Orleans, LA 70112 504-988-5263 medsch@tulane.edu