Proposal for a Collaborative Approach to Clinical Teaching

Abstract

Evidence suggests that inexperienced clinical teachers are often controlling and noninteractive. Adult learning theory states that mature students prefer shared and self-directed learning and that skillful teachers favor facilitating discussions over transmitting knowledge. Similarly, education research shows that effective clinical teachers invest in relationships with learners, ask questions to diagnose learners, communicate complex information clearly, and provide meaningful feedback. On the basis of these principles, we propose a collaborative approach to clinical teaching that has 4 essential components: (1) establish a relationship with the learner, (2) diagnose the learner, (3) use teaching frameworks that engage learners, and (4) develop teaching scripts and a personal philosophy. This article includes suggestions for creating a positive learning climate, asking higher-order questions, providing meaningful feedback, and developing teaching scripts. We believe that practicing this approach, which emphasizes respectful teacher-learner relationships, improves the quality of every clinical teaching encounter.Mayo Clin Proc. 2009;84(4):339-344 R elationships between clinical teachers and students are created by learning medicine and serving patients, so medical education should be founded on a collaborative approach. However, our research showed that teachers rarely use the adult learning principles of encouraging dialogue, asking questions, and giving meaningful feedback.

Success of a Faculty Development Program for Teachers at the Mayo Clinic

“…A basic summary of the curricular content of FEED was previously published. 13 These topics are taught by experienced, award-winning teachers in 2-hour sessions involving small groups of fewer than 20 participants, and using interactive and discussion-based learning methods that are intended to role model effective clinical teaching. Each of the 2-hour sessions addresses 1 of the basic topics listed above and is offered multiple times during 1 year to allow faculty members to attend at times that are convenient for their schedules.…”

“…12 The goals of remediation should model recognized qualities of excellent teachers, which would include the abilities to create a positive learning environment, engage in dialogue, provide effective feedback, diagnose learners' needs, use known teaching methods, and develop personal philosophies of teaching. 13 There is mixed evidence on the interaction between faculty's preintervention skills and the effectiveness of a faculty development program. Litzelman et al 14 found that teachers with low learner baseline ratings showed poor improvement in teaching performance after receiving feedback, compared to teachers with high baseline ratings.…”

“…We created a faculty development program that was structured on recognized components of clinical teaching, 13 such as creating a positive learning climate, 16 asking questions effectively, [17][18][19] diagnosing the learner's needs, [20][21][22][23][24][25] and giving feedback. 26,27 The goals of this study were to describe a Mayo Clinic faculty development program on clinical teaching, and to determine whether poor clinical teachers would experience different levels of improvement in teaching effectiveness scores than the best teachers, after exposure to faculty development.…”

Understanding Clinical Teachers: Looking Beyond Assessment Scores

“…A systematic review of clinical teaching research found that interpersonal relationships between teachers and learners are important. 13 Successful teaching behaviors include demonstrating enthusiasm, 14 promoting dialogue, 15 and spending extra time with learners. 16 Clinical teachers should also know basic skills like asking questions, diagnosing learners, utilizing teaching frameworks, and giving meaningful feedback.…”

“…16 Clinical teachers should also know basic skills like asking questions, diagnosing learners, utilizing teaching frameworks, and giving meaningful feedback. 15 Finally, master teachers seem to prefer facilitating discussions over transmitting knowledge, [17][18][19] and they promote learner growth by balancing challenge and support. 20 Despite the abundance of research on clinical teaching, a limitation of many previous studies has been the use of Published online August 11, 2010 heterogeneous samples of teachers.…”