Supreeya Wongtra-ngan,MD.,MHPEd

CLINICAL COMPETENCIES  Factual Knowledge  Technical Skill  Problem Solving Skill  Communication Skill  Manners & Etiquette

ผู้เรียนของเราคือใคร

Principles of learning  Learning climate  Internal motivation  Meaningful learning  Learning objective  Identify resources  Practice  Reinforcement

• Bedside teaching • OPD, OR, LR • Ward rounds • Independent patient contact • Simulation, Role play • Case discussion • Home visit • etc

 Clear understanding of the task  Supervised practice  Direct experience  Repetition  Persistence

ผู้ป่วยนั้น สำคัญไฉน ???

In what may be called the natural method of teaching the student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end. Sir William Osler,1904

 Be on time  Insist that students arrive on time  Plan the clinical teaching session

 Involve the patients  Inform the charge nurse  Involve all the students  Insist on a standard format

 Use a problem –solving approach  Conduct discussion away from the patient  Do not try to do too much

การเตรียมพร้อม ประเมินผลการทดลองฝึก ปฏิบัติ สรุปข้อสำคัญหลังพบผู้ป่วย สรุปข้อสำคัญ ก่อนนศ. พบผป. (Debriefing) (Briefing) ช่วงพบผู้ป่วย

Clinical learning cycle Briefing Briefing patient students Debriefing Clinical session practice Including the Patient

Briefing the patient  Explaining the purpose  Seeking co-operation  Negotiating roles  Preparing patient Briefing students  Providing a framework  Generating ideas

Clinical practice  Modelling appropriate behaviors  Using questions Debriefing  Analysis discoveries  Discussing insights

• Informed consent • Confidentiality • Truth telling • Maternal-fetal conflict • Quality end of life care • Conflict of interest • etc

 Risk factors  Disease prevention  Life style  Environment  Family health  Occupational health  etc

• Multiple choice question • Modified essay question • Short/ Long case • Case report • Structured oral exam • Objective Structured Clinical Examination (OSCE) • OSLER • Direct observation: check list, rating scale • Standardized patient

CLINICAL COMPETENCIES  Factual Knowledge  Technical Skill  Problem Solving Skill  Communication Skill  Manners & Etiquette

To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all Osler 1903