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

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)

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

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

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

How people learn? AffectivePsychomotor Cognitive

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

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

Structuring the practical Set Dialogue Closure

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

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

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

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

Four-step approach 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) Video CCTV Practical director Table instructor

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

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

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

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

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

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

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