Why Precept? 11 Reasons The Teaching Roles of a Preceptor Finding a Clerkship The Skill of Teaching Reflect on Teaching Effectiveness Continuous Learning as a Teacher The Effects of Precepting on a Practice Getting Ready Characteristics of an Ideal Preceptor Preparing Your Staff for Educational Roles Teaching Others to Teach Institutional Learning Objectives Unconscious Bias Identifying Potential Unconscious Bias Implicit Bias in Learners Create a Plan to Address Unconscious Bias Conflicts of Interest Discuss Conflicts of Interest With Learners Inequities in Clinical and Health Education Counteracting Inequities Address Inequities Establish Systems to Address Inequities Model Professional Behavior Students' Professional Identities Cultivate Professional Relationships The Importance of Professional Boundaries

Developing Residents' Teaching Skills Motivating Residents to Teach Complying With LCME Standards Residents: Assess Your Teaching Skills

Creating the Clinical Learning Environment Your Learner’s First Day General First Steps Orientation Scheduling Welcoming a Learner Identify the Unique Characteristics of Your Clinical Setting Managing Clinical Workflow Interprofessional Teams and Community Resources Help the Team Integrate Learners Celebrate Learner Diversity Elicit the Needs of Diverse Learners Develop Culturally Relevant Individualized Learning Plans Teach Cultural Understanding for Improved Learning Value the Learner's Place in the Clinical Setting Set Expectations at the Start Adjust to Meet Changing Needs Clarify Roles and Responsibilities Individual Commitment to a Group Effort Getting to Know Your Student Maximizing Learning at Your Practice Setting Expectations with Your Learner Setting Expectations for Feedback Discuss Institutional Learning Objectives With Your Learner Goal-Directed Learning Collaborate With the Learner to Prioritize Goals Integrate the Learner's Goals Monitor A Learner's Progress Towards Goals Create Opportunities to Meet Goals Adjust Goals As Needed Self-Reflection Ask Learners to Engage in Self-Reflection Discuss Observations Resulting from Self-Reflection Follow Up on Learner's Self-Reflections

Adult Learning Principles Developing a Learner's Skill Set Varying Your Teaching Style Differences Between Feedback and Evaluation Introduction to Clinical Teaching Methods Use a Variety of Teaching Methods Adjust Your Teaching Methods Focus Teaching to Improve Retention Students With Little Clinical Experience Cultivating a Growth Mindset in Learners Teaching Residents Clinical Supervision of Residents Contribute to Professional Identity Formation Promote Professional Identity Across the Clinical Team Precepting Scenarios A Medical Mistake The Talkative Patient With Many Symptoms Well-Child Checkups (and Beyond) Infectious Mononucleosis in a Young Athlete First Diagnosis of Hypertension Toxoplasmosis Counseling in a Pregnant Woman Post-traumatic Stress Disorder in Primary Care Patients The Mouth Is More Than Just Teeth When Will I Know It All? Quality of Care The Rewards of Teaching Chronic Headache Closing the Deal Patient With Hyperglycemia Inviting Hippocrates Along on a Home Visit Geriatric Patient With Fatigue Weight Loss Cardiac Risk Assessment Anticipatory Precepting Teaching About Patients with Complexity Your Role in the Patient Visit The Learner's Role in Patient Education Teaching After the Visit

Progressive Learning Model ACGME Competencies About Family Medicine Clerkships Principles of Family Medicine Learning Objectives Acute Care Learning Objectives Chronic Diseases Learning Objectives Health Promotion and Disease Prevention Learning Objectives The Role of Family Medicine Learning Objectives General Medical Knowledge Procedures Teaching Evidence-Based Medicine Use of EBM Guidelines and Point-of-Care Resources Answer Clinical Questions Using EBM Guidelines Coach Learners in Asking Clinical Questions Collaboratively Identify Clinical Questions Collaboratively Identify Clinical Questions The Patient-Centered Medical Home (PCMH) Quality Improvement

Five-Step Microskills POwER Precepting SNAPPS Model What If Model TIPPS: Teaching in the Presence of Patients TIPPS: Preparing the Patient for a Student to Be Involved in the Visit Where to Precept Home Visits Role Play Intervening in a Clinical Encounter Chart Stimulated Recall

Physician Well-Being Discuss Well-Being With Learners Identify Barriers to Well-Being With Your Learners Model Behaviors to Enhance Well-Being Identify Conflict Use Inquiry to Manage Conflict Coach Learners in Conflict Management Strategies Role Model Professional Boundaries With Learners Discuss Professional Boundaries With Learners Assist Learners in Developing Their Professional Boundaries Collaborate With Learners on Conflicts of Interest Role Model Strategies to Mitigate Conflicts of Interest

Student Use of Electronic Health Records EHR Communication Skills 4 Get Model Billing in Teaching Settings Documentation Guidelines

Overview of Giving Feedback Feedback is Essential for Learning Timely and Actionable Feedback Assure Learner Comprehension of Feedback Use Feedback to Set SMART Goals Formative Feedback and Summative Evaluation Providing Formative Feedback and Summative Evaluation Integrate Formative Feedback Into Summative Evaluation Collaborate With Learners in the Feedback Process Feedback Levels Mid-Rotation Feedback Feedback Traps Bi-Directional Feedback Seek Feedback From Learners Enhance Your Teaching with Learner Feedback Develop Learners' Feedback Skills After the Feedback Sandwich Model ARCH Model Five-Step Microskills Ask-Tell-Ask Model

Evaluating Learners Direct Observation Midpoint Review Sample Written Comments Summative Evaluation RIME Evaluation Model Evaluating Students Evaluating Residents Basic Performance Documentation Timely Summative Evaluations Review Evaluations With Learners Build the Best Evaluation Tools

Recognize the Learner in Difficulty Communicating Learner Difficulty Classifying Learner Difficulties Individualized Learning Plans Preventing Problems Rapport Problems Impaired Learners Gifted Learners

End-of-Clerkship Meeting Writing Letters of Recommendation Preceptor Evaluations

October 2024: Enrich Answers to Clinical Questions using EBM Resources September 2024: Make Your Formative Feedback Collaborative August 2024: Enhance Professional Identity Formation in a Clinical Setting May 2024: Empower Learners With a Growth Mindset April 2024: Self-Reflection in Educators November 2023: Get Inspired with 17 Patient-Encounter Scenarios October 2023: How to Teach Evidence-Based Medicine September 2023: Feedback Levels Help Identify Your Feedback Goals August 2023: How to Decide Where to Precept June 2023: Use Self-Reflection to Identify Barriers to Well-Being  May 2023: Adding to a Learner's Skill Set April 2023: Help Learners Manage Conflict in the Clinical Setting March 2023: Managing Clinical Workflow with Your Learner February 2023: Model Receptiveness to Feedback for Your Learners November 2022: Show Learners How to Cultivate Professional Relationships July 2022: Identify Types of Learner Difficulty June 2022: Develop Your Learners' Teaching Skills May 2022: Set Shared Learning Objectives with Every Learner April 2022: Three Tips to Effectively Teach in the Presence of Patients March 2022: The Benefits of Direct Observation February 2022: Model Professional Behavior for Your Learners October 2021: A Collaborative Feedback Environment September 2021: Documenting Learner Performance August 2021: Help Learners Self-Reflect July 2021: Prepare Your Staff to Educate New Learners June 2021: Continuously Enhance Your Clinical Teaching Skills May 2021: Integrate Learners Into Your Team April 2021: Help Learners Develop Their Professional Identity March 2021: Personalized Teaching Skills Assessment Tool on Teaching February 2021: Communicating About a Learner in Difficulty November 2020: Look for Opportunities for Direct Observation October 2020: Virtual Professional Boundaries September 2020: Ensure Your Learners Recognize Feedback June 2020: Role Modeling Inclusivity May 2020: Tips for Welcoming Students Back to Clinic in a Pandemic World April 2020: Precepting in the Time of COVID-19 March 2020: Teaching the Student With Little Clinical Experience February 2020: Your Learners' Well-Being December 2019: Save Time By Frequently Assessing Learners November 2019: Role Model Feedback for Your Learners October 2019: A Growth Mindset Benefits Everybody September 2019: Prep for an Efficient Day Teaching in the Clinic August 2019: Recognize Learners in Difficulty with the HEART Acronym July 2019: Coach Students in Conflict Management June 2019: Engage Your Students with Goal-Directed Precepting May 2019: Find New Content Quickly March 2019: A Model for Structuring Your Student’s Clerkship February 2019: Prepare Your Patients to Have Students Involved in the Visit January 2019: Bringing New Learners Into Your Clinic November 2018: Write Learner Evaluations More Quickly October 2018: Using the Three Levels of Feedback When Precepting September 2018: Applying Adult Learning Principles to Your Precepting August 2018: Setting Expectations with Your Students July 2018: Providing Preventive Patient Care with Your Students June 2018: Implementing the Revised Student Documentation Guidelines from CMS May 2018: Prepare Your Patients to Have Students Involved in Their Visit April 2018: How Students Can Improve the Quality of Care in Your Practice March 2018: Increase the Efficiency of Your Precepting Using the Five-Step Microskills Model December 2017: Earn Up to 40 CME Credits November 2017: Empower Your Staff to Help Teach Your Students October 2017: Avoid Common Feedback Traps September 2017: Use Direct Observation for Easier Student Evaluations August 2017: Your Medical Students Can Improve Patient Care July 2017: Optimize Your Students' Use of Electronic Health Records June 2017: Structure Your Student's Clerkship Experience May 2017: Help Learners Succeed at Your Clinic April 2017: Using the RIME Model to Assess Your Learners March 2017: Writing Meaningful Comments on Your Learner Evaluations February 2017: Turn Brief Conversations Into Teaching Opportunities January 2017: Earn Up to 40 CME Credits December 2016: Varying Your Teaching Styles November 2016: Supporting Learners in Difficulty October 2016: Resources for Teaching Evidence-Based Medicine September 2016: Providing Better Feedback to Your Students August 2016: Getting to Know New Students at Your Practice July 2016: Teaching the Skill of Self-Assessment June 2016: Teaching About Patients With Complexity May 2016: Complete List of New TeachingPhysician.org Pages March 2016: The New Site Has Launched! February 2016: Two New Pages about Teaching in the Presence of Patients January 2016: New Interview About Teaching in the Presence of Patients

Resident Path New Preceptor Path Established Preceptor Path New Learner Path Teacher and Professionalism Teacher and Learner Teacher and Assessment Teacher and Content Teacher and Environment

New Interview About Teaching in the Presence of Patients

Can a clinical preceptor schedule daily direct observations with medical students without falling far behind in productivity? Many preceptors may think that observing their students in the presence of patients is too time-intensive and inefficient. However, Kenya Sekoni, MD, FAAFP, an assistant professor at the College of Human Medicine at Michigan State University, believes that teaching in the presence of patients can actually be a time-efficient strategy.

In a new audio interview that appears at TeachingPhysician.org, Dr Sekoni spoke at length about her successful techniques for teaching her students in front of her patients. The following excerpt is just a portion of the tips and strategies that Dr Sekoni recently shared with the editor of Teaching Physician, Dr Dennis Baker, PhD.

Dennis Baker: Can you tell us a couple of reasons that you believe teaching in the presence of patients is a good clinical teaching strategy?

Kenya Sekoni: When I was in private practice, the only way that I was allowed to precept was to ensure that our productivity would not go down. And that’s the primary reason that I began looking for ways to teach in front of the patients. I think it allows me to be an effective clinical teacher for both the student and my patient. The students themselves have said that they feel like I’m not only listening to them to be able to redirect them, but that I can actively correct their clinical approach as they’re doing the exam right on the spot.

Dennis Baker: Before you share a situation with us where you’ve done this, can you tell me about how you have seen patients respond?

Kenya Sekoni: My patients…absolutely adore having the students with them! They’ve told me that it gives them better insight as to how we as clinicians are thinking about their signs and symptoms. Even when we’re using scary terminology, they love hearing us explain it and hearing the student take a stab at explaining it.

Dennis Baker: Can you go ahead and give us an example of using the strategies that you are sharing?

Kenya Sekoni: Let me share how I conduct a physical exam. I use the acronym “PI.” “P” [is] for “priming” the student. First, I have [the student] look back at the last office visit, and have them think of the patient’s chief complaint. The second thing that I’m doing…is where the “I” of the “PI” comes in. With the “introduction,” I introduce or set the stage for both the patient and the student, and will oftentimes do that in the patient’s presence. That way, they’re primed as to how the interview process is going to go.

 

Dr Sekoni shares many more tips in the full interview, such as:

  • Where she sits in the room during the exam
  • How she asks the patient for permission to have the student perform the exam
  • Why she asks the student to offer the differential in the presence of the patient

Log in to teachingphysician.org to hear the entire interview and find more practical tips on teaching in the presence of patients.