1. Teaching Learners in the Ambulatory Clinical Setting Tali Bogler, May Loganathan, Kim Lazare June 18, 2015 Knowles’ Adult Learning Principles The learner should be prepared for the learning program An environment conducive to learning should be created A mutual planning procedure should involve the learner in deciding what he/she will learn Involving learners in diagnosing their own learning needs Co-create learning objectives Design own learning plans Help learners carry out their learning plans Involve learners in evaluating their own learning Domains of Learning Cognitive domain - recall, recognition of facts Psychomotor domain - technical/procedural skills Affective domain - attitude, values, language

2. PatientsChartsEducational Techniques Case discussionChart reviewRole play and simulation Case reviewChart-simulated recallShort didactic presentation Direct observationCriterion chart review Teaching Strategies Case Discussion: student sees patient then presents to preceptor Case Review: review a large number of cases at the end Direct Observation: supervision of interviewing, P/E, clinical skills Chart Review: review chart by chart with learner Chart-simulated Recall: choose two charts to review in detail Criterion Chart Review: audit charts on your own time Role Play/Simulation: role play to recreate an office visit Short Didactic Presentation: the learner presents a topic to teacher/team

3. THE DEFENSIVE LEARNER learning contract​ use concepts of process learning to diffuse behaviour act in a collegial manner with students​ psychological safety​ involve students in patient discussions with colleagues learning contract improves learner's self- assessment skills rather than having to respond to your comments involving them in discussions with colleagues about difficult patients you have THE SLOW LEARNER lack of knowledge of office routines: ask an office assistant or secretary to provide assistance use role modeling to demonstrate that providing clear and brief explanations to patients is better than lengthy ones use role play to practice focused history taking review prevalence and likelihood of particular diseases book fewer patients limit your own discussion between patients THE UNPROFESSIONAL LEARNER work with learner to identify causes: learner: cognitive, clinical skills, personal values, medical illness, substance abuse preceptor: teaching skills, personal values, educational knowledge, medical illness system: work load, time demands, learner support, preceptor supports be direct; discuss what it conveys and how unprofessionalism can impact patient care try to get an understanding of why the learner may have this problem Strategies for Dealing With Challenging Learning Situations

4. Kolb’s Learning Styles

5. References