Clinical teaching strategies for physicians.

Abstract

This paper provides advice for the clinical teacher. It reviews the aims of clinical teaching and the skills and strategies required for the teacher. All too often the emphasis in clinical teaching is on an accumulation of theoretical knowledge rather than on the development of clinical competencies required by the student. These include accumulation and recording of information about patients, performance of physical examination, performance of skill procedures, interpretation of data, solving scientific and professional problems, communicating information reliably, familiarity with health care services and facilities and appropriate attitudes to patients and allied health care workers. Teaching methods include bedside small group tutorials, clinical ward rounds, active participation as a member of the patient care team, independent patient contact in outpatients and inpatients, small group discussions away from the bedside, utilisation of model simulation and role playing, video tape and audiotapes and discussion of patient management problems. Each method is better suited for some goals than for others.Considerations such as the clinical teacher as a role model and who should do the clinical teaching are important. Features of an effective clinical teacher include group instructional skills, attitudes to patients, applied problem solving, student-centred instructional strategies, humanistic orientation, the subject expertise and a challenging approach.Clinical teaching activities require preparation and planning followed by conscientious implementation of the tactics selected. Guidelines can be given which may be of assistance at each of these stages.