Five Clinical Microskills


Model for Teaching

Attendings, fellows, and residents have a difficult time finding ways to integrate their teaching responsibilities into the clinic. This can be attributed to the busy clinic schedules, but also because teaching can add time to an already full day and, those who are in an instructor position may not know of any time-efficient instructional strategies.

By using the teaching method known as the One-minute Preceptor, integrating teaching into the busy clinic can be a more beneficial approach than simply trying to teach on the fly. The One-minute Preceptor provides a framework for instructor-student interactions. It is brief and easy to learn.

The One-minute Preceptor involves using 5-microskills when discussing a patient. It can not only improve integration of teaching into the clinic, but these microskills also help instructors to better diagnose the learner's knowledge and understanding as well as guiding their feedback to the learners.


The Five-Clinical Microskills

  1. Obtain a commitment 
    Ask the learner what he/she thinks is going regarding a patient
  2. Probe for supporting evidence
    After learner has committed to what he/she thinks, ask "why" before you ever offer your opinion
  3. Teach general rules
    Now you likely know what the learner needs or wants to know so provide a general rule that targets this case but that can also be generalized to similar cases
  4. Reinforce what was right
    If the learner did something correctly, inform them, as they may not realize it (be specific)
  5. Correct mistakes
    If the learner made a mistake, find an appropriate time/place to discuss what took place and how to correct it in the future


Materials


Resources

Websites

  1. Preceptor Microskills. Strategies in Clinical Teaching Website; University of Kansas School of Medicine - Wichita [Website Link]
  2. The One Minute Preceptor: Microskills of Clinical Teaching; Richard Sarkin, M.D., Ed.M. [Website Link]
  3. Steps in the One-Minute Preceptor Method. Alberta Rural Family Medicine Network. [Website Link]

Articles/Books

  1. Aagaard E, Teherani A, Irby DM. Effectiveness of the one-minute manager preceptor model for diagnosing the patient and the learner: Proof of concept. Acad Med 2004; 79:42-49.
  2. Instructor's Guide for Teaching Residents to Teach. Gary Dunnington, MD and Debra DaRosa, PhD. Association for Surgical Education.
  3. Irby DM, Aagaard E, Teherani A. Teaching points identified by preceptors observing one-minute preceptor and traditional preceptor encounters. Acad Med 2004; 79;50-55.
  4. Neher JO, Gordon KC, Meyer B, Stevens N. A five- step "microskills" model of clinical teaching. Journal of the American Board of Family Practice 1992; 5:419 -424.
  5. Roth LM, Gaspar DL, Porcerelli J. A Patient-Centered Approach to the One-minute Preceptor. Department of Family Medicine, Wayne State University. [Article Link]