Practical Exercise: Structured Learning for Hands-On Practice

1. AoTrauma Regional Hand Course • Running a practical exercie A N Moharram MD, FRCSEd Professor of Orthopedic Surgeon, Cairo University Egypt Precourse meeting Dubai UAE October 10, 2011

2. What is a practical exercise? • « I hear and I forget. I see and I remember. I do and I underestand» Confucius (551 BC- 497 BC)

3. What is a practical ? • Structured and interactive learning • Demonstration of new skill • Explanation of the steps • Talking through procedure • Practicing new skill • Reflection on performance • Feedback & support

4. Who is Practical Director? • Planning of the session • Preparing effective and stimulating session • Following the A,B,C of learning • Focusing on learning outcomes • Communication with participants

5. What does table instructor do? • Works with the director • One-on-one instruction and support • Delivers constructive support • Works within assigned group • Observe and interact with all group members

6. How people learn? Cognitive Affective Psychomotor

7. Key points • Skill is not reflex action • Complex movements require practice • Reinforced practice • Environmental factors • Feedback

8. Before the session • Sufficient numbers of artificial bones, Instruments, and implants • Review all the video/DVD • Preview the video(table instructors) • Flip chart (key steps) • Has enough time been allocated • Time for supervised practice • Time for feedback • Time for evaluation

9. Structuring the practical • Set • Dialogue • Closure

10. Set • Room temperature, light, and quietness • Does all the equipment work? Do you know how to use them? • Welcome the participants • Keep the introduction brief and to the point

11. Dialogue • Keep in mind that adult learners need to know the application of what you want them to learn or to do

12. Dialogue • Divide the content into short manageable section • Do you have the attention of the all learners • Consider the safety issues • Apply the four-step approach

13. Closure • Reflect on outcomes and key learning points • Address questions • Summarize main points • Deliver a final “take-home” message

14. Four-step approach Video CCTV Practical director • 1- Silent demonstration • 2- Demonstration with explanation • 3-Learner talks through the task (faculty performs the task) • 4- Learner perform the task (50% time of the session) Table instructor

15. Closure • Show the finished result • Summarize the key points • Invite questions • Strong positive “take home message”

16. Role of the table instructor • Reinforcement of the correct procedure and give constructive feedback • Explain the steps • Discuss the principles involved before the hand-on practice

17. Faculty Pitfalls • Lecturing at the work station • Faculty doing the skill • Disinterested faculty • “ I-don’t-use-this-implant” attitude • Unfamiliarity with equipment & instruments • Telling learners that you have better way of performing the skill

18. Student Pitfalls • Talking through the demonstration • Taking pictures or video instead of doing the exercise • Experimenting with unsolicited or untaught techniques • A general lack of interest • Not interacting with other participants • Inappropriate level of participation: • Monopolizing • Rushing ahead • Too complacent

19. Some advices Dealing with some personalities • Beware alternate agendas • Direct disruptive or monopolizing learners • Silence the chatterboxes • Engage the silent learners

20. “Excellence is an art won by training and habituation” Aristole (384 BC-322BC)

21. Table Instructor Checklist • Internalize the four-step approach • Familiarize yourself with exercise procedure • Get to know the learners at your table • Reinforce the demonstration before hands-on • Stick to the script – don’t show off • Be aware of time • Deliver constructive feedback • Provide positive reinforcement and lots of praise