CL

IN
IC
Te a n u J o s e G . Ta m ay o

AL Keziah Caclini
Jeanette D. Dumagas
G i s e l l e A n n P. Ta b a b a

TEMarielle Louise S.
Wa s a w a s

AC
HI
Clinical teaching is a form of interpersonal communication between two people - a
teacher and a learner. "The teaching-learning process is a human transaction
involving the teacher, learner and learning group in a set of dynamic
interrelationships. Teaching is a human relational problem" (Bradford 1958, p. 135).
As a "relational problem," successful teaching and learning requires that the teacher
understand and make constructive use of four factors:

1. The role of the teacher and the knowledge, attitudes and skills that the teacher
brings to the relationship,
2. The role of the learners and the experiences and knowledge that the learners
bring to the relationship,
3. The conditions or external influences which enhance the teaching-learning
process, and,
4. The types of interactions which occur between teacher and learner.

Factors analysis groups most behaviors and characteristics of excellent clinical

teachers into four roles: Physician, Teacher, Supervisor, and Person.

The Physician is the expert and the source of all knowledge. There is considerable
discrepancy between the Physician's level of experience and wisdom and that of the
students. This discrepancy is the reason the medical teacher and students are
together. The physician is also responsible to school administrators, specialty
boards and hospital credentials committees for evaluating and certifying the
competency of students. The physician is the upholder of professional standards
and is a socializing agent, a member of a professional discipline.

As a Teacher, the medical educator is acutely aware of the needs and aspirations of
students but does not automatically assume it will be possible to provide them
everything they need. The Teacher can listen, question, paraphrase, encourage or
doubt students but cannot always provide for them.

As a Supervisor, the medical educator demonstrates procedures, provides practice,

observes and assesses performance and provides feedback.

Finally, as a Person, the educator develops an atmosphere of sufficient trust that the
students are comfortable sharing ideas, feelings and thoughts. The physician-
educator does not necessarily have to like the students but does need to accept
their needs and imperfections. The Person may provide significant personal help
and support outside the formal teaching setting.

What does clinical teaching mean?

Teaching is much more than passionate information transmission and behavior
management. Excellent teachers focus on individual students' learning growth, and
clinical teaching enables them to do this by:

Monitoring and evaluating their impact on learning and adapting the lesson to meet
the needs of each student - rather than expecting the student to keep up regardless
of their circumstances
Using evidence about what each student knows and understands at the start of the
teaching period to inform their teaching interventions
Targeting their assessment and teaching practices to maximize the information
obtained about their impact and optimize the chances of improving student learning
On the basis of the above, constructing appropriate teaching and learning
environments for every student, whatever their developmental stage and current
abilities
Continuously evaluating the impact of their teaching, to inform next steps.
As a clinical teacher you need to:

Act as a role model for students (e.g. dress appropriately, act courteously etc)
Clearly articulate the criteria used for student assessment
Clearly demonstrate and explain clinical material
Clearly demonstrate and explain clinical treatment techniques
Demonstrate how theoretical knowledge can be applied in a clinical situation
Monitor students clinical progress regularly, critically and constructively
Encourage students to develop rapport and empathy with the patient and/or
his or her family.

Clinical teaching often involves presentation of a case, assessment and discussion

of the case.
As a clinical teacher it is important that you:

Encourage students to present the facts of the case to you (without you
intervening to offer a diagnosis)
Encourage students to explain the rational behind their thinking (you can
probe this through the use of what and why questions)
Provide general rules targeted to the learners level of understanding (for
example, When this happens, do this...")
Tell them what they did right
Correct their mistakes in a constructive manner.

PROS

Case-based

One-on-one: preceptorship
 Experiential

Meaningful

Opportunities for critique

Shared focus between teacher and student

Promotes clinical examination, diagnostic and management skills

Orienting the students to the ward, routine and the people they are likely to
encounter during their placement

Ensuring students receive a handover sheet and are allocated tea breaks with
other team members;

Introducing students to the people involved in the care of their allocated

patients, for example, pharmacists and physiotherapists, when discussing
needs and changes to care;

Encouraging students to be involved in every aspect of their patients care.

This means adjusting their role as their scope of practice allows. For example,
a student may not be allowed to perform the laying of a skin graft. However,
they can be involved in setting up the trolley and environment, positioning
and comforting the patient, reviewing the order and policy or opening sterile
packets to assist in the process;

Collaborating with students, telling them why you are doing things and
involving them in the decision-making and problem-solving processes.

Allowing the nursing student to practice as independently as possible.

Encouraging her or him to recognize the healthcare priorities for their
allocated patient load, to develop their own time plan, deliver their care,
handover and document their actions while offering appropriate prompting
and constructive ideas for future improvement.

Exposure to cutting-edge medical care with research and innovation,

including new medications, technology, and procedures

Clinical practice skills are keen and current because of the level of care
required for a higher acuity patient population

CONS

No formal teaching training

Learners of diverse backgrounds and motivation
 Stressful health care environment
Case is a teaching case
Juggling stresses of personal role
Labour intensive

REFERENCES

Bradford, L. P. The teaching-learning transaction. Adult Education, 1958; 8(3):135-

145.

Ullian, J. A. Medical student and resident perceptions of clinical teaching. Healthcare

Chapter News (National Society for Performance and Instruction) 1986; 1(4): 4-5.

University of Queensland. Clinical Teaching, 2016. Retrieved from

https://www.uq.edu.au/tutors/clinical -teaching