Practicing the Skills of
“The One Minute Preceptor”
March 21, 2015
Big Sky, MT
Directions for practice session:
Below are 3 case vignettes you can use to practice the 5 microskills of the “One Minute
Preceptor” (OMP). (Refer to the OMP card provided.) Select one of the cases provided or
use one of your own. Working in groups of 3, select someone to play the role of a learner,
a preceptor and an observer.
Role descriptions:
Learner: Remember that learners make mistakes and modify your presentation
accordingly! Don’t offer your ideas too freely, or the preceptor will be left with nothing
to do.
Preceptor: Use as many of the microskills as you can. Remember that these skills are not
necessarily intuitive and may not be part of your regular teaching scripts. Thus, you will
need to be purposefully aware of the microskills as you practice them.
Observer: Take brief notes on the dialogue, cues and responses. What microskills are
being used? What suggestions can you make for improvement?
I. Medical Student: Coughing Case (Adapted from case developed by D. Irby)
 Learner: Ms. Porter is a 44-year-old woman who has a chief complaint of a cough
for the past few weeks. She had been in her usual state of good health until a few
weeks ago when she developed what sounds like an upper respiratory infection
including a runny nose and cough. The runny nose resolved after a few days, but
the cough has persisted. The cough is worse at night and now keeps her awake.
She has had no fever, weight loss, change in appetite, and is not bringing up any
sputum. She recalls having had coughs in the past, but not as bad as this one. She
thinks she might have had bronchitis a few times when she was a child. She
doesn’t smoke. On physical exam, she looks well and is in no distress. Her vital
signs are within normal limits. Her exam is unremarkable, but she did cough a
few times. Her lungs were clear.” You think the patient’s problem is post-nasal
drip.
 Preceptor: Using the OMP, discuss your concerns about the possibility that the
patient is suffering from asthma.
II. Resident: Bronchitis (Adapted from case developed by R. Morrison)
 Learner: I just saw a 25-year old woman in clinic who has had a non-productive
cough for 3 weeks. Her vitals were normal, her lungs sounded clear, and she
hasn’t been having any fevers. She probably just has a viral bronchitis, but she
Lynne Robins & Peggy Schlesinger
OMP Cases
Big Sky, MT 3.21.2015
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begged me for some antibiotics so I gave her a z pack and asked her to come back
in a week.
 Preceptor: Using the OMP, express your deep concern about the resident’s
decision to prescribe antibiotics when they were not warranted.
III. Headaches (Adapted from case developed by D. Irby)
 Learner: "I just saw a 48-year-old man with a chief complaint of headaches. This
patient has been in his normal state of good health recently. However, for the past
few months, he has been having headaches. The headaches seem to begin in the
afternoon and get progressively worse. By the evening, he usually has to take
either aspirin or Tylenol or both, and must lie down to relieve the pain. After an
hour or so, the pain is better, although the headache is not completely gone. By
morning after a good night’s sleep, the headache is no longer present. These
headaches are now occurring about three times per week. They are not associated
with an aura, nausea, vomiting, or blurry vision. The patient works as an
investment banker and says his job is stressful. He describes things at home as
going well. He has had a history of similar headaches off and on in the past, but
his headaches have not been a problem for quite some time. On physical exam, he
appears well developed, well nourished, in no apparent distress. His vital signs are
within normal limits including a blood pressure of 120/80. His HEENT exam is
unremarkable, except I didn’t get a very good look at his fundi. His lung, heart
and abdominal exam were normal. His neurological exam seemed fine to me. I’m
concerned he might be having migraine headaches or even a brain tumor.
 Preceptor: Using the OMP, redirect the learner toward a diagnosis of tension
headache.
Lynne Robins & Peggy Schlesinger
OMP Cases
Big Sky, MT 3.21.2015
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