Clinic Teaching Model One
– Student Observes Attending
Tips for Using Model One:
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Recognize the opportunity to role model positive doctor/patient interaction and clinical skills to the learner
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Advise student what to focus on while observing (use a focused teaching agenda) so actively learning while observing
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Before you go in to see the patient, tell the stud ent the patient’s presenting complaint…not the diagnosis
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Remember this model can become quite boring unless you engage the student by asking what they observed, summarize their thoughts, or discuss key findings.
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Think aloud outside the room so the student can hear your reasoning process.
Clinic Teaching Model Two – Student Independently Sees the Patient
Tips for Using Model Two
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Give a time limit for length of time the student/resident should spend doing at
FOCUSED history and physical exam
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When you go in to see the patient after the student presenting his/her findings outside the patient’s room, start the conversation with “(Name of student) told me” to verify student’s findings, but also so the patient doesn’t feel the attendings exam is totally redundant and that their time was subsequently wasted.
 Don’t try to teach everything about every patient…pick one or two learning points only to keep things moving along.
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It may be necessary depending on the level of learner to tell you when they have completed t he patient care task you’ve assigned them. For example, “call me after you’ve taken the focused history and we’ll do the physical exam together.”
This should also be done when needing to directly observe the learner perform parts of the physical exam so feedback can be given.
Clinic Teaching Model Three
– Student Independently Sees the Patient Followed by Intensive Socratic Questioning
Tips for Using Model Three:

Plan questions in advance (i.e. teaching script) to strategically question the learning through the clinical reasoning process
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Establish a future learning issue that the learner will explore after clinic
 When reviewing labs, don’t tell the student whether the results are normal; rather have them interpret the findings.

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Use this model once or maybe twice during clinic as it takes significant time to do it well, but is worth the investment on at least one and preferably two patients.
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Asky hypothetical and open ended questions that walk the learner through the reasoning process
Clinic Teaching Model Four – Student Independently Sees the Patient and Then
Presents the Patient to the Attending Inside the Patient Room
Tips for Using Model Four:

Carefully pick the right patients for this model knowing they would be comfortable with it.
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Note that this is a time saving model because the student is presenting his or her findings to you in the presence of the patient who can then validate the accuracy and completeness of the student’s presentation.
General Teaching Tips Regardless of Model Used
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Orient you r learners, patients, and staff to the learner’s role and responsibilities in clinic. Welcome your learners to the clinic to create a positive learning climate.
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Directly observe the learner at least once and preferably more often in the beginning so feedback can be provided.
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Introduce the learner to the patient using a positive tone and referring to the learners as part of your “team”; or have the learner demonstrate to you what words and tone they use when introducing themselves to the patient.
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If you ask a learner a question inside a patient’s room, be sure it is one they will likely get correct. Be prepared with a proper response if you get an incorrect answer to protect the clinical credibility of the learner.
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Every now and then, if a learner asks you a question, turn it around and ask what they think the answer is. This enables the instructor to better understand the level of understanding of the learner, and build on what they already know or reinforce what they do know.
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Distribute learning objectives to your learners that outline what they should know and be able to do BEFORE they attend clinic, and what they should expect to learn from the clinic experience.
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Promote active learning throughout the clinic time, using a mix of all of the models described above.
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If the clinic schedule is extra busy, arrange at the start of the clinic when you will meet with the learner to answer their questions and discuss the patients seen.
 Have a focused teaching agenda…don’t try to teach everything about every patient or clinic will never end on time.
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Be a positive role model as a clinician demonstrating positive behaviors associated with working with staff and in patient care.
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Provide feedback by stating specifically what the learner did well and what they could improve upon.

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