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Teaching in

Teaching in. OPD Setting. Teaching and Learning in Ambulatory Care Setting: A Thematic Review of the Literature Acad Med 70(1995): 898-909-931. Outline. pros and cons of OPD teaching effective OPD teacher Quality of OPD education. Pros & Cons. Pros pt seen only in OPD: chronic illness

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Teaching in

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  1. Teaching in OPD Setting Teaching and Learning in Ambulatory Care Setting: A Thematic Review of the Literature Acad Med 70(1995): 898-909-931

  2. Outline • pros and cons of OPD teaching • effective OPD teacher • Quality of OPD education

  3. Pros & Cons • Pros • pt seen only in OPD: chronic illness • continuity of care • health promotion and disease prevention • communication and negotiation skill • social, financial, and ethical aspects of medical care • Cons • variability • unpredictability • immediacy

  4. Context of OPD Education • patient problems encountered • type • frequency • continuity of care • working environment of the clinic

  5. Patient Encountered • type • common disease => similar • diversity • depends • frequency • often: HT, DM, LBP • others complaint - few cases

  6. Patient Encountered • continuity of care • repeat visit = FU + non FU • Why important? • more medical and non-medical problems • realistic • acquainted • ~ duration • < 10% in Wk 4 => 50% in Wk 8 • support longitudinal rotation

  7. Numerous demand brief segmented teaching rush teaching short demonstration, role modeling brief discussion little time for answer Seldom observation infrequently taught clinical decision making rare reflection teaching embedded in patient care physicians’ personal style What happens in OPD

  8. Educational Interaction • between instructor and learner • amount of contact • 20-30% of cases were observed • duration of contact • 6-15 minutes • content of verbal interaction

  9. Verbal Interaction

  10. Verbal Interaction

  11. Content of Conversation • About family and psychosocial • 6-20% (even in Fam Med OPD) • infrequently provide feedback • most 3-6% (range 0-16%) • positive feedback > negative feedback • rarely discuss about options

  12. Wrong Answer • How teacher correct? • provide ‘opportunity space’ • hint or leading question • reframing the question • treat as plausible but need of further consideration • soft and face-saving strategies

  13. Clinical Teachers • effective clinical teacher • physician role model • effective supervisor • dynamic teacher • supportive person

  14. Physician Role Model • Knowledgeable • clinical competent • good rapport with patient

  15. Effective Supervisor • give opportunity for patient care • review patient with learner • involve learner in patient care • give direction • provide constructive feedback

  16. Dynamic Teacher • teaching with enthusiastic • made an effort to teach • spent time with individual • available and accessible • engage in dialogue • give explanation • ask and answer question

  17. Supportive Person • easy and fun to work with • friendly • helpful • caring • valuing learner as individual

  18. Recommendation • increase continuity • improve collaboration & SDL • provide faculty development • model and teach to the learners • observe and feedback • encourage independent learning • supplement OPD instruction • reflect upon and improve teaching

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