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THE ONE MINUTE PRECEPTOR: NOTES FOR WORKSHOP FACILITATORS

 These notes are intended to serve as a guide when "The One Minute Preceptor (OMP): Microskills for Clinical Teaching" workshop is being presented. This workshop was originally developed by Kay Gordon and Barbara Meyer from the Department of Family Medicine at the University of Washington School of Medicine. The microskills model was described by Jon Neher and Kay Gordon in an article titled "A Five-Step ‘Microskills’ Teaching Model of Clinical Teaching" (JABFP. 1992;5:419-424). The OMP workshop handout that accompanies these notes was designed by David Irby when he was at the University of Washington School of Medicine.

Most clinical teaching takes place in the context of busy clinical practice where time is at a premium. Models for case-based teaching are familiar to nearly everyone who teaches in a clinical setting. A medical learner presents a patient case to a preceptor after the learner has independently gathered information about a patient including the history and physical examination. The preceptor must then decide what is the best way to create opportunities for the learner to learn in addition to providing care for the patient. There are many models for case-based teaching that a preceptor might use including role modeling, questioning, expert consultation, mini-lecture, thinking out loud, joint problem solving, and promoting self-directed learning.

The OMP is a case-based teaching model that is a hybrid of asking questioning and providing expert consultation. After the needs of a learner are identified, tailored instruction is provided. The OMP is used when the teacher knows something about a case that the learner needs or wants to know. The OMP enables teachers to effectively assess, instruct and provide feedback more efficiently. The OMP can be used by either faculty or residents when they are precepting nearly any level of medical learner.

The OMP workshop will define and provide opportunities to practice five microskills:

1. Get a commitment.
What do you think is going on?
2. Probe for supporting evidence.
Why do you think this?
3. Teach general rules.
4. Reinforce what was done right.
Tell them what they did right and the effect it had.
5. Correct mistakes.
Tell them what they did right.
Tell them what they did not do right.
Tell them how to improve for the next time.

The OMP workshop can last anywhere from one to three hours in length depending on how much time is allowed to teach the five microskills, for discussion, and for participants to practice during the workshop simulations. Medical students and/or residents should be invited to attend the workshop to provide additional input throughout the workshop and to make the simulation exercises as realistic as possible.

The OMP workshop should begin with introductions by the workshop leader and each of the workshop participants. Questions such as who are you and why did you choose to attend the workshop are important to get things started and to set the tone that the workshop will be participatory. The first two pages of the workshop handout are reviewed to provide an overview of the OMP model and an explanation of the context as to how this model might be used. A scripted scenario, Scenario One: the Case of a Painful Ear, is read at the front of the room by two volunteers from the audience. After the scenario is read, the audience is asked to comment on the scenario. Following the comments, Scenario Two is read. The audience is asked what has changed, how is Scenario One different from Scenario Two?

The five microskills are now taught to the participants by the workshop leader. The text from each page of the handout should be summarized, but not read verbatim. Overheads or slides have been effectively used by some workshop leaders to emphasize important concepts. Workshop participants should be encouraged to ask questions and make comments. Once the five microskills are discussed, Scenario Three: The Case of an Adolescent Girl is read by two volunteers. The various microskills used in Scenario Three should be identified and discussed by the audience.

Next, workshop participants have an opportunity to practice the OMP model. The Microskill Precepting Simulation page is reviewed. 3" X 5" OMP summary sheets are distributed to each workshop participant and reviewed (see enclosed OMP summary sheet page). Participants are divided into groups of three participants per group. Roles are determined in each group for a preceptor, a learner, and an observer. Each participant should now review only his/her own role. The simulations should last about 3-5 minutes. Each simulation begins as the person playing the learner role reads the scripted case presentation. The person playing the preceptor role then tries to use each of the five microskills of the OMP model. The observer silently observes. After completing the simulations, the preceptor should be allowed to critique his/her performance first, followed by the learner and then the observer. The simulations are most effective when medical students or residents are invited to attend the workshop and play the roles of the learners. Successful simulations must seem realistic to workshop participants. Ideally, each workshop participant will have an opportunity to play the role of the preceptor.

The workshop concludes with the entire group reassembling and having a chance to review what happened in the simulations. Participants should be asked what they thought of the workshop and what they learned. The workshop leader should provide a final summation. A workshop evaluation form should be completed by each participant at the conclusion of the workshop (see enclosed sample OMP workshop evaluation form).

Good luck. Have fun. Please contact me if you have any questions.

 

Richard Sarkin, M.D.
Children’s Hospital of Buffalo
219 Bryant Street
Buffalo, NY 14222
(716) 878-7288
rsarkin@upa.chob.edu

 


 

THE ONE MINUTE PRECEPTOR SUMMARY SHEETS

1. Make several copies of this page
2. Cut into 3" X 5" sheets
3. Distribute to each workshop participant before the practice simulations portion of the workshop.

THE ONE MINUTE PRECEPTOR THE ONE MINUTE PRECEPTOR

1. Get a Commitment. 1. Get a Commitment.

What do you think is going on? What do you think is going on?

2. Probe for Supporting Evidence. 2. Probe for Supporting Evidence.

Why do you think this? Why do you think this?
What led to your diagnosis or decision? What led to your diagnosis or decision?
What else did you consider? What else did you consider?

3. Teach General Rules. 3. Teach General Rules.

4. Tell Them What They Did Right 4. Tell Them What They Did Right
and the Effect It Had. and the Effect It Had.

5. Correct Mistakes. 5. Correct Mistakes.

Tell them what they did right. Tell them what they did right.
Tell them what they didn't do right. Tell them what they didn't do right.
Tell them how to improve for the next time. Tell them how to improve for the next time.

 

THE ONE MINUTE PRECEPTOR THE ONE MINUTE PRECEPTOR

1. Get a Commitment. 1. Get a Commitment.

What do you think is going on? What do you think is going on?

2. Probe for Supporting Evidence. 2. Probe for Supporting Evidence.

Why do you think this? Why do you think this?
What led to your diagnosis or decision? What led to your diagnosis or decision?
What else did you consider? What else did you consider?

3. Teach General Rules. 3. Teach General Rules.

4. Tell Them What They Did Right 4. Tell Them What They Did Right
and the Effect It Had. and the Effect It Had.

5. Correct Mistakes. 5. Correct Mistakes.

Tell them what they did right. Tell them what they did right.
Tell them what they didn't do right. Tell them what they didn't do right.
Tell them how to improve for the next time. Tell them how to improve for the next time.

The One Minute Preceptor
Workshop Evaluation

 

Please evaluate each of the following categories:

Poor Fair Good Very Good Excellent
Workshop leader’s presentation skills 1 2 3 4 5
Workshop handouts 1 2 3 4 5
Relevance to your needs 1 2 3 4 5
Overall workshop effectiveness 1 2 3 4 5

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