Pedagogical strategies used in clinical medical education: an observational study

Abstract

BackgroundClinical teaching is a complex learning situation influenced by the learning content, the setting and the participants' actions and interactions. Few empirical studies have been conducted in order to explore how clinical supervision is carried out in authentic situations. In this study we explore how clinical teaching is carried out in a clinical environment with medical students.MethodsFollowing an ethnographic approach looking for meaning patterns, similarities and differences in how clinical teachers manage clinical teaching; non-participant observations and informal interviews were conducted during a four month period 2004-2005. The setting was at a teaching hospital in Sweden. The participants were clinical teachers and their 4th year medical students taking a course in surgery. The observations were guided by the aim of the study. Observational notes and notes from informal interviews were transcribed after each observation and all data material was analysed qualitatively.ResultsSeven pedagogical strategies were found to be applied, namely: 1) Questions and answers, 2) Lecturing, 3) Piloting, 4) Prompting, 5) Supplementing, 6) Demonstrating, and 7) Intervening.ConclusionsThis study contributes to previous research in describing a repertoire of pedagogical strategies used in clinical education. The findings showed that three superordinate qualitatively different ways of teaching could be identified that fit Ramsden's model. Each of these pedagogical strategies encompass different focus in teaching; either a focus on the teacher's knowledge and behaviour or the student's behaviour and understanding. We suggest that an increased awareness of the strategies in use will increase clinical teachers' teaching skills and the consequences they will have on the students' ability to learn. The pedagogical strategies need to be considered and scrutinized in further research in order to verify their impact on students' learning.

The use of assisted performance within an online social network to develop reflective reasoning in undergraduate physiotherapy students

“…Students often feel that their role within the health system is undervalued at best, and merely tolerated at worst, when in fact they have the potential to play an important role (Nilsson et al 2010). Their development as clinicians relies in part not only on their understanding of their role within the multi-disciplinary team but also in terms of the value that they perceive they bring to it.…”

What does it mean to be a good teacher and clinical supervisor in medical education?

“…Nevertheless, the teaching role is a complex one as it involves being an information provider, role model, facilitator, assessor, planner, as well as a resource developer (Harden and Crosby 2000). Clinical supervision is a central and similarly complex task for many medical teachers (Nilsson et al 2010;Taylor et al 2007). This type of teaching is characterised by the fact that it is often unplanned or opportunistic due to the unpredictable nature of medical cases.…”

“…The teacher's approach may also be related to students' approaches to learning as a teachercentred teaching approach has been associated with reproduction and a surface approach to learning whilst a student-centred teaching approach may instead support understanding and meaning making and thereby better learning outcomes (Kember 1997;Martin et al 2000;Trigwell et al 1999). Going back to clinical supervision Nilsson et al (2010) explored how this was carried out in authentic situations and identified seven pedagogical strategies. These strategies were linked to ways of understanding teaching and learning as student-or teacher-focused and each of these teaching perspectives bear consequences on the teacher's focus in clinical teaching (Nilsson et al 2010).…”

“…Going back to clinical supervision Nilsson et al (2010) explored how this was carried out in authentic situations and identified seven pedagogical strategies. These strategies were linked to ways of understanding teaching and learning as student-or teacher-focused and each of these teaching perspectives bear consequences on the teacher's focus in clinical teaching (Nilsson et al 2010). …”

Uma análise crítica do discurso de preceptores em processo de formação pedagógica

“…Entre os problemas relatados, o de maior interesse para este trabalho é o da capacitação profissional, mais especificamente o aspecto pedagógico dessa prática, elemento de altíssima relevância quando se pensam os objetivos da preceptoria e sua qualidade, tal como afirmam diversos estudos (Botti & Rego, 2008Missaka & Ribeiro, 2011;Nilsson, Pennbrant, Pilhammar, & Wenestam, 2010;Paton, 2010;Smedley, 2008;Trajman, Assunção, Venturi, Tobias, Toschi, & Brant, 2009). …”