Using the One-Minute Preceptor Model to Improve the Skills and Confidence of Novice Preceptors: A Pilot Study.

Revisiting “The One-Minute Preceptor”

The One-Minute Preceptor (OMP) model to teach diagnostic reasoning and Reporter, Interpreter, Manager, and Educator (RIME) framework to measure progress are used in physician training. Little is known about the use of these tools in nurse practitioner (NP) training. Precepting NP trainees at the Veterans Affairs (VA) is not standardized. A standardized approach to precepting NP residency trainees using the OMP model and RIME scoring was evaluated for improvement and helpfulness. A quality-improvement project with two Plan-Do-Study-Act (PDSA) cycles were conducted over a 12-week period. Mean RIME scores, preceptor self-efficacy, and use of teaching skills were measured preintervention and postintervention. Data were analyzed using a paired sample t -test and descriptive statistics. A convenience sample of preceptors and trainees was recruited from a large VA medical center. A 1-hour workshop educated preceptors with role playing and return demonstrations on OMP techniques and RIME scoring. The teachings were applied to standardize precepting and assess diagnostic reasoning. Trainee self-scoring and results triggered conversations to fulfil the identified gaps. Mean RIME scores improved (1.62 [0.17] vs. 2.23 [0.38], p < .001) post 12-week intervention. Mean RIME scores improved between PDSA cycle 1 and cycle 2 (2.07 [0.25] vs. 2.48 [0.39], p < .001). Preceptors (91%) and trainees (100%) found the OMP model and RIME framework helpful. Use of the OMP improved diagnostic reasoning in NP trainees. The OMP and RIME framework provided standardization of precepting and trainee discussions on improvements.

Preceptors play a vital role in nurse practitioners' (NPs) clinical education. Based on Bandura's self-efficacy theory, improvement of NPs' self-efficacy is likely to lead to positive changes in behavior. Thus, it can enhance their willingness to precept and increase readiness for a preceptor role. The aims of this pilot study were to develop an NP preceptor training program and to evaluate the program following implementation. The one-minute preceptor (OMP) model has been used among other health care disciplines and can promote effective and efficient communication. In the first phase of this pilot study, an NP preceptor training program to teach NPs about the OMP model was created. For the second phase of this project, a pilot test of the program was implemented and evaluated. Nine clinical NPs participated in the study. Surveys were administered at three different points to determine whether the participants' self-efficacy as a preceptor and willingness to become a preceptor improved after participation. Results demonstrated that NP preceptor training improved multiple aspects of participants' self-efficacy as NP preceptors and positively affected their decision to participate in preceptorship.

The One-Minute Preceptor (OMP) model of faculty development is used widely to improve teaching, but its effect on teaching behavior has not been assessed. We aim to evaluate the effect of this intervention on residents' teaching skills. Randomized controlled trial. Inpatient teaching services at both a tertiary care hospital and a Veterans Administration Medical Center affiliated with a University Medical Center. Participants included 57 second- and third-year internal medicine residents that were randomized to the intervention group (n = 28) or to the control group (n = 29). The intervention was a 1-hour session incorporating lecture, group discussion, and role-play. Primary outcome measures were resident self-report and learner ratings of resident performance of the OMP teaching behaviors. Residents assigned to the intervention group reported statistically significant changes in all behaviors (P <.05). Eighty-seven percent of residents rated the intervention as "useful or very useful" on a 1-5 point scale with a mean of 4.28. Student ratings of teacher performance showed improvements in all skills except "Teaching General Rules." Learners of the residents in the intervention group reported increased motivation to do outside reading when compared to learners of the control residents. Ratings of overall teaching effectiveness were not significantly different between the 2 groups. The OMP model is a brief and easy-to-administer intervention that provides modest improvements in residents' teaching skills.

Introduction: Early Clinical Exposure (ECE) was incorporated into the Competency-based Medical Education (CBME) curriculum in 2019. ECE in a classroom setting is conducted through Clinical Case Discussion (CCD) using paper-based clinical case scenarios. The assessment pattern of CBME and Maharashtra University of Health Sciences (MUHS) includes clinical case-based questions. Therefore, assessing and developing clinical reasoning skills and critical thinking has become the need of the hour. Aim: To measure the effectiveness of the modified One-minute Preceptor (OMP) model as a teaching-learning tool for CCD to enhance the knowledge and reasoning skills of Phase I Bachelor of Medicine Bachelor of Surgery (MBBS) students and to assess the perception of students and faculty towards the modified OMP model. Materials and Methods: This prospective interventional study was conducted in the Department of Biochemistry at Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India from February 2020 to May 2020. Out of 250 Phase I MBBS students, 180 who had given consent and participated in all the sessions were included. Eight faculty members voluntarily participated in the study. The faculty involved in CCD for the control and study groups were different and selected through randomisation. After a didactic lecture, a pretest was administered, and then students were divided into Control group A (n=90) and Study group B (n=90). For CCD, the modified OMP model was used for the study group and the traditional unstructured method for the control group. A post-test was given after CCD, and feedback was collected from faculty and students. Quantitative analysis of the feedback was done using a 5-point Likert scale, and open-ended questions were qualitatively assessed. Pretest and post-test scores were analysed using an unpaired t-test. Learning gain was measured, and program evaluation was conducted using Kirkpatrick’s model. Results: There was a statistically significant difference in the post-test scores obtained by the control group and study group (p-value &lt;0.001). A higher normalised learning gain (0.83) was observed in the study group. The modified OMP model was perceived as an effective, interactive teaching-learning tool for CCD by both students and faculty. Conclusion: CCD using the modified OMP model significantly improved knowledge, critical thinking, and reasoning skills of students. Even after modifications to the original OMP model, the effectiveness of this model for preclinical subjects remains unaffected.

Background: The one-minute preceptor (OMP) model was developed to effectively and efficiently teach learners while simultaneously addressing patient needs. This study was conducted to determine if third- and fourth-year medical students prefer the OMP model over the traditional precepting model and what teaching points they needed from the clinical encounters.Methods: Third- and fourth-year students (N = 164) at two medical schools completed a questionnaire and prompts on teaching points in response to viewing two videotaped precepting encounters. Differences between OMP and traditional precepting scores were computed using a factorial repeated measures analysis of co-variance (ANCOVA). Teaching points were coded and counted.Results: Students preferred the OMP precepting model to the traditional teaching model (p = 0.001). While the desired teaching points changed as the case presentation/discussion progressed, students were most interested in learning about the clinical presentation or natural progression of the disease regardless of teaching model used.Conclusions: Students rate the OMP as a more effective model of teaching than the traditional model. The teaching points desired by students change as the case presentation/discussion unfolds.Work carried out at: University of California, San Francisco, Office of Medical Education and University of California, Irvine, Department of Family Medicine

Teaching models provide a systemic framework for didactic and clinical teaching. The One-Minute Preceptor (OMP) is one teaching model, providing five microskills to organize a learning experience for students in the clinical environment. This review aims to integrate the literature on the OMP model by highlighting potential use for nurse practitioners while identifying directions for future research. Electronic databases were searched from December 2017 to January 2018 for articles published in English. The databases included PubMed, CINAHL, and MEDLINE using terms including "preceptor," "clinical teaching," "time-efficient teaching," and "precepting." Of 32 articles in the final search, only 12 experimental quantitative studies were included in the synthesis and 20 descriptive studies in the discussion. The OMP model is supported by literature for its effectiveness as a teaching model and preference by students and preceptors. It has been shown to increase teaching techniques including feedback and assessment of students' clinical reasoning. The OMP model has the potential to overcome clinicians' barriers to precepting nurse practitioner students. Future research may evaluate the use of this model specific to nurse practitioner preceptors and students, perceived time benefits in clinical teaching, overall improvement in clinical teaching, and use in interprofessional precepting.

Clinician educators who teach dental residents in the fast-paced clinic, such as in emergency dental care, often face numerous challenges. Time for clinical teaching is limited in the setting of significant clinical workload, complex medical conditions of patients, and the need for documentation and satisfaction of clinic productivity goals at the same time. Little is known about effective clinical teaching methods or tools that could enrich learning opportunities and increase dental residents' clinical competency in a busy clinic environment when there are time constraints to teach. The One-Minute Preceptor (OMP) model is an innovative teaching method originally used for clinical teaching in family medicine residency trainings that has been shown to be an effective teaching tool, resulting in the increased confidence and clinical skills of residents. It focuses on identifying the needs of each individual learner, teaching to the needs, and providing feedback by using a 5 micro-skill approach: get a commitment, probe for supporting evidence, teach general rules, reinforce what was right, and correct mistakes. We propose using the OMP model to teach dental residents in a dental emergency clinical setting to allow the clinician educator to take full advantage of the entire encounter to maximize the time available for teaching and improve clinical teaching efficacy and efficiency and for dental residents to practice clinical reasoning and identify their own knowledge gaps in emergency dental care settings.Knowledge Transfer Statement:The recommendations from this article can be used by postgraduate dental training programs to improve clinical teaching and ensure dental residents' education and competency.

One Minute Preceptor Model: The Impact of Incorporating an Interactive Didactic Session Into Surgery Intern Orientation.

To compare the One-Minute Preceptor (OMP) and traditional models of ambulatory teaching in terms of the preceptors' (1) ability to correctly diagnose patients' medical problems, (2) ability to rate students' skills and confidence in doing so, and (3) satisfaction with both models. A within-groups experimental design study was conducted with 116 preceptors at seven universities in 2000. Participants viewed scripted, videotaped precepting encounters of both models using two cases and were asked to rate students' abilities, their confidence in rating the students' abilities, and the effectiveness and efficiency of the teaching encounters. Preceptors who viewed the videotapes of the OMP model were equally or better able to correctly diagnose the patients' medical conditions than those viewing the traditional model. Preceptors viewing the OMP rated students' abilities higher on history taking/physical examination, presentations, clinical reasoning, and fund of knowledge than did those viewing the traditional model. Preceptors viewing the OMP rated themselves as more confident in rating students' abilities in presentation, clinical reasoning, and fund of knowledge. Preceptors rated the OMP as more effective and more efficient than the traditional model. Preceptors viewing scripted, videotaped teaching encounters using the OMP model were equal to or better able to correctly diagnose patients' medical problems, had greater self-confidence in rating students, and rated the encounter as more effective and efficient than when viewing the traditional model.

Introduction: Knowledge and competencies regarding Pharmacology are found difficult to be taught by the traditional teaching methodologies alone. One minute preceptor (OMP) model is an innovative method of teaching and learning activity which is being used to improve reasoning skills in clinical settings but also can be used with modification to improve work place based learning in nonclinical subjects. We conducted OMP for the first time among undergraduate students with the aim of imparting better understanding of basic competencies in Pharmacology and better clinical application of concepts. Materials and Methods: This was a quasi experimental interventional study. Participants included 60 undergraduate second BBS students that were randomized to the OMP group (n = 30) or to the traditional group (n = 30) and 12 faculty members. Six competencies of Pharmacology were selected and validated by the content experts followed by development and validation of six case scenarios from the topics chemotherapy and cardiovascular system (CVS) with regards to the particular competency. One case scenario was developed for one competency. The selected topics had already been covered in didactic lecture. Validated pre/post-test questionnaire and feedback perception questionnaire were developed. Faculty and students were sensitized with the OMP method of teaching with short interactive lecture and role play. Immediate cognitive gain was assessed using pre- and post-tests for each intervention. Formative assessment after 2 months was done to assess long term impact using structured viva. All the questions were based on clinical application with regards to the competencies. Students’ and faculty perceptions were analyzed using feedback questionnaire on a 5-point Likert’s scale. Paired t- test was adopted to assess pre/post scores for immediate effect of learning. Unpaired t-test was conducted to compare viva scores between two groups to assess long term impact. Results: Analysis of results of the both group revealed that OMP group scoring was significantly higher than the traditional group .The average perception on Likert’s scale was between 4(agree) and 5(strongly agree). The OMP model of teaching learning in pharmacology was well perceived by the students and faculty. Teaching skills of the faculty were also improved. Conclusion: Faculties and students rate OMP as more effective model of teaching than traditional model. Students feel confident in applying concepts in clinical settings. OMP promotes self directed learning .and encompasses all three domains- cognitive, psychomotor and affective. Keyword: OMP, Undergraduates, Competencies, Pharmacology

While several models of medical student instruction in the ambulatory setting exist, few have been formally studied. We wished to assess the impact of a faculty development workshop based on the One-Minute Preceptor model on the amount and quality of feedback in the outpatient setting. Ambulatory teaching behaviors were studied during consecutive outpatient precepting sessions before and after 3 faculty development workshops. Student-teacher interactions were assessed using audiotapes of teaching encounters coded through qualitative techniques, and surveys of teacher, learner, and patient satisfaction. Ambulatory internal medicine clinic in a tertiary care medical center. Nine board-certified internist faculty preceptors and 44 third-year medical students. Three 90-minute faculty development seminars based on the One-Minute Preceptor teaching model. Ninety-four encounters with 18577 utterances were recorded, half before and half after the seminars. After the workshops, the proportion of utterances that contained feedback increased from 17% to 22% (P =.09) and was more likely to be specific (9% vs 15%; P =.02). After the workshops, teachers reported that the learning encounters were more successful (P =.03) and that they were better at letting the students reach their own Conclusions (P =.001), at evaluating the learners (P =.03), and at creating plans for post-encounter learning (P =.02). The workshops had no effect on the duration of the student-teacher encounter or on student or patient satisfaction with the encounters. Brief, interactive, faculty development workshops based on the One-Minute Preceptor model of clinical teaching resulted in modest improvements in the quality of feedback delivered in the ambulatory setting.

Objective To analyze the effect of the One-minute Preceptor model for preceptors who work at the emergency department of a maternity teaching hospital.Methods A quantitative intervention study conducted with Obstetrics and Gynecology residency preceptors at a maternity teaching hospital in northeastern Brazil. Three stages were performed: 1) a preintervention survey with the residents; 2) planning and execution of a pedagogical training course for the preceptors, which involved a lecture and a dramatization about the One-Minute Preceptor model; and 3) thirty days after the intervention, the residents answered another survey about the model and its repercussions and advantages.Results The preintervention assessment with the residents showed that 91.7% agreed that there were discrepancies regarding the teaching model among the preceptors. After the training, all preceptors agreed that the model engages the student in the decision-making process, and that they would apply it to their routine. The postintervention results showed that 95.8% agreed that the model is more inviting than traditional teaching approaches. There was a perception of improvement in learning among 70.9% of the residents. In addition, the present study found a significant change in feedback before and after implementing the model, from 20.8% to 66.7%.Conclusion The training course of preceptors in the One-Minute Preceptor model proved to be efficient in providing formative feedback to residents in the emergency department of a maternity school. Further studies are needed to assess the consolidation of the methodology in the long term.

Response

Precepting is when a medical educator listens to a learner's presentation and must teach and assess the learner while rendering safe patient care. A popular framework for this type of educational encounter is the one-minute preceptor model, which can work for learners at all skill levels. This workshop was created to develop skills of all teaching faculty, regardless of medical specialty, in precepting. The workshop is based on Kolb's experiential learning theory. A PowerPoint presentation delivers the core abstract concepts. The PowerPoint allows for discussion of participants' prior precepting experiences, including both challenges and successes. The workshop ends with role-plays for participants to practice their skills and a facilitated debrief to aid individual reflection. Twelve role-plays were created for use in the workshop; these were then reviewed by someone in the matching specialty to enhance authenticity. Participants completed a survey after the workshop to evaluate the session. This presentation was delivered 26 times to 392 participants at 16 different teaching hospitals. Twenty-one different medical specialties and subspecialties were represented. Ninety-seven percent of participants stated they would use the information presented in the workshop often or daily. There were conflicting comments about the role-plays. The negative comments centered around (a) personal difficulty participating in the role-plays and (b) the role-plays not being related to the learning. Discussion and role-play can be an effective way to instruct educators in use of the one-minute preceptor as a framework for teaching.