supreeya wongtra-ngan,md.,mhped
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Principle of Clinical Teaching. Supreeya Wongtra-ngan,MD.,MHPEd. เรียน คณบดี - PowerPoint PPT PresentationTRANSCRIPT
Supreeya Wongtra-ngan,MD.,MHPEd
เรยน คณบดผมเขยนบนทกนดวยความเปนหวงคณภาพของ
นกศกษาปท ๖ในปจจบน ซงผมเพงสอบไปเมอเรวๆนเขาสามารถตอบคำาถามเกยวกบโรคและการวนจฉยแยก
โรคตางๆได แตไมสามารถรวบรวมขอมลจากผปวย การซกประวตและการตรวจรางกายกทำาไดแย อาการ
และอาการแสดงหลายอยางถกขามไป ทงการสบคน ทางหองปฏบตการ แสดงใหเหนวาเขาไมสามารถนำา
ความรทางทฤษฎมาประยกตใชในการแกปญหาผปวย ผมแนใจวาเกดจากการทมเวลานอยในชนคลนก
จงขอใหคณะฯขยายเวลาเรยนออกไปอกหนงปเพอเพมพนทกษะทางคลนกมากขน
ขอแสดงความนบถออยางยง
นพ. เพมพน เตมลน
What is Clinical Teaching?
Where does it take place?
When does it take place?
• Bedside teaching• OPD, OR, LR• Ward rounds• Independent patient contact• Simulation, Role play• Case discussion• Home visit• etc
ผเรยนของเราคอใคร
Principles of learningLearning climateInternal motivationMeaningful learningLearning objectiveIdentify resourcesPracticeReinforcement
Lecture
ReadingAudiovisual
DemonstrationGroup discussion
Practice by doing
Teach others
AverageRetention Rate
5%10%
20%30%
50%
75%
80%
National Training Laboratories, Bethel, Main,USA
The Learning Pyramid
• Be enthusiatic• Interested in the well-being of students• Prepare for your teaching• Authentic medical problems• How to improve teaching and students’ learning
Ronald J Markert, 2001
CLINICAL COMPETENCIES
FACTUAL KNOWLEDGETECHNICAL SKILLPROBLEM SOLVING SKILLCOMMUNICATION SKILLMANNERS & ETIQUETTE
RecallComprehension
ApplicationAnalysis
SynthesisEvaluation
Cognitive domain
Bloom 1956
CLINICAL COMPETENCIES
FACTUAL KNOWLEDGETECHNICAL SKILLPROBLEM SOLVING SKILLCOMMUNICATION SKILLMANNERS & ETIQUETTE
PerceptionSet
Guided responseMechanism
Complex overt response
Psychomotor domain
Simpson
ผปวยนนสำาคญไฉน???
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In what may be called the naturalmethod of teaching the student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end.
Sir William Osler,1904
Clear understanding of the taskSupervised practiceDirect experienceRepetitionPersistence
Be on timeInsist that students arrive on time
Plan the clinical teaching session
Involve the patientsInform the charge nurseInvolve all the studentsInsist on a standard format
Use a problem –solving approach
Conduct discussion away from the patientDo not try to do too much
การเตรยมพรอม
ประเมนผล การทดลองฝกปฏบต
สรปขอสำาคญหลงพบผปวย สรปขอสำาคญกอนนศ.พบผป.
ชวงพบผปวย
CLINICAL COMPETENCIES
FACTUAL KNOWLEDGETECHNICAL SKILLPROBLEM SOLVING SKILLCOMMUNICATION SKILLMANNERS & ETIQUETTE
You are driving a car.
On one big storm night.
You are passing a station.
There are three people who are waiting for the bus
One doctor who saved your life before.One guy/lady who is someone you have been dreaming to get married to.
One old lady who is dying.
You can only take one passenger, which one you will choose? Please explain your reason.
" Give the car key to the doctor, let the doctor take the old lady to the hospital and I stay to wait for the bus with the lady of my dream!"
Everyone I know think the above answer is the best answer, but there is no one (including myself) can think of this answer first.
Is that because we never want to give up any advantage we held in
our hands (the car key)? Sometimes, we would gain more if
we were able to give up our stubbornness, limitations, and
advantage.
CLINICAL COMPETENCIES
FACTUAL KNOWLEDGETECHNICAL SKILLPROBLEM SOLVING SKILLCOMMUNICATION SKILLMANNERS & ETIQUETTE
• Informed consent• Confidentiality• Truth telling• Maternal-fetal conflict• Quality end of life care• Conflict of interest• etc
Objective
Learning experience
Learner
Evaluation
Education cycle
• Multiple choice question• Modified essay question• Short/ Long case• Case report• Structured oral exam• Objective Structured Clinical Examination• OSLER• Direct observation: check list, rating scale• Standardized patient
To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all
Osler 1903
Good night