The Five Microskills of the One-Minute Preceptor
Get a Commitment
Begin by asking the learner to commit to a decision. This allows the student to process the information and leads to deeper learning. It asks the learner to commit to a diagnosis or treatment option, rather than just agreeing with the preceptor’s plan. Avoid prompting the learner or suggesting any actions at this point. Ask:
- What do you think is going on here?
- What do you want to do next?
- What kind of investigations are indicated?
- What would be your treatment plan?
Probe for Supporting Evidence
Explore the learner’s thought process. This gives you the opportunity to assess the learner’s thought process and to determine if there are any gaps in reasoning or misconceptions. The purpose is to identify any learning gaps so you can determine what they don’t know and what you can teach them. Ask:
- What lead to your conclusion?
- What other alternatives did you consider?
- How did you rule out other options?
- What made you choose that particular treatment?
Teach General Rules
Learning a way to approach the problem is more effective than learning isolated facts. The student learns to organize their knowledge and generalize it for other situations. Base the general principle you are teaching on any learning gaps you identified in the previous step. This can be about symptoms, differential diagnosis, treatment, and more. Tips:
- A way of dealing with this problem is...
- Choose a single, relevant teaching point.
- Check the learner for understanding of the principle you are teaching.
- Avoid anecdotes or personal preferences.
Reinforce what was done well
Reinforcing good behaviors is an essential part of learning and ensures that students continue using them. Focus on behaviors that were beneficial to the patient, colleague or clinic. The best reinforcement is specific and focused. Tips:
- Specifically, you did a good job of...
- Here’s why that is important...
- Avoid general praise like, "Great job!"
Correct any mistakes
This step helps ensure that correct knowledge has been gained and creates a foundation for improvement. Avoiding confrontation and ignoring errors ensures they will be repeated. Focus on future behavior rather than dwelling on the error and teach the student how to avoid making the same mistake next time. Begin with the student self-assessment as a launching off point. Tips:
- What would you do differently next time?
- How would you improve your encounter?
- Make recommendations for improving performance
- Provide resources, if appropriate.
Do's and Don'ts
- Allow the learner to problem solve.
- Diagnose the learner’s understanding of key concepts and ideas.
- Check for learner understanding.
- Help the learner generalize their learning.
- Be specific and focus on one key idea per session.
- Ask for more data about the patient.
- Provide all the answers.
- Ask for isolated facts or textbook knowledge.
- Cover too many issues or ideas.
- Give general praise or recommendations
- The One Minute Preceptor: 5 Microskills for One-on-One Teaching
- A Patient-Centered Approach to the One-minute Preceptor
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