Transcript The Minnesota Rural Health School

The Minnesota Rural Health
School
The One Minute Preceptor
Presented by Terry L. Lewis
MPAS, PA-C
The One Minute Preceptor
Used and reformatted with the
permission of David Irby, PhD
Get a Commitment
• Student presents the
case
• Preceptor-What do
you think is going on
here?
• Rationale - How does
the student interpret
the data?
Examples
• “What do you think is going on here?”
• “What would you like to accomplish during
this visit?”
• “Why do you think the patient has been
non-compliant?”
Probe for Supporting Evidence
• Student has presented
case and looks to you
for confirmation or
alternative
• Preceptor - Ask for
evidence
• Rationale - Identifies
thought process
Examples
• “What were the major
findings that led to
your conclusions?”
• “What else did you
consider? What kept
you from that choice?”
Teach General Rules
• Provide general rules,
concepts or
considerations, and
target them to the
learner’s level of
understanding - When
this happens, do this…
• Rationale understanding better
Examples
• “If the patient only has cellulitis, incision and
drainage is not possible. You have to wait until
the area becomes fluctuant to drain it.”
• “Patients with UTIs usually experience pain with
urination, increased frequency and urgency. The
UA should show bacteria, and WBCs and may
have RBCs.”
Tell them what they did right!
• Take the first chance
to comment on: 1) the
specific good work
and 2) the effect it
had.
• Rationale - Skills in
learners that are not
well established need
to be reinforced.
Examples
• “Obviously you considered the patient’s finances
in your selection of a drug. Your sensitivity to this
will certainly contribute to improving her
compliance.”
• “You did not jump into her complaint of
abdominal pain, but kept that open until the
patient revealed her real agenda. That will save a
lot of unnecessary workup and will get to the real
heart of her concerns first.”
Correct Mistakes
• When the learner’s
work has
demonstrated mistakes
or misunderstanding
• Correct quickly
• Rationale - Mistakes
left unattended have a
good chance of being
repeated!!!
Examples
• “You might be right that this child’s symptoms are
probably due to a viral upper respiratory infection,
but you can’t be sure it isn’t otitis media unless
you’ve examined the ears.”
• “I agree that the patient is probably drug-seeking,
but we still need to do a careful history and
physical examination.”
Constructive Feedback
• Is descriptive rather
than evaluative
• Is specific rather than
general
• Focuses on behavior
rather than personality
• Shares information
• Is well-timed
Constructive Feedback
Continued
• Is appropriate in
amount
• Is offered rather than
imposed
• Can be verified
• Pays attention to
consequences
• Builds relationships