Practice Based Teaching
As GP supervisors your role in the teaching and training of registrars is pivotal. It is well recognised that workplace based teaching is a powerful way to learn and as supervisors you are the key to the apprenticeship training, that is the hallmark of our training program.
Hayes (1) comments that there are many characteristics of a good General Practitioner, and that clinical supervisors, should be trying to demonstrate these characteristics to their registrars.
Characteristics of a good general practitioner
- Sound working knowledge of a wide range of health and disease processes
- Sound clinical skills that enable a wide range of problems to be managed
- Communication skills that make them approachable and understanding
- Understanding of their role in the health care system
- Understanding of population health principles, even though the focus of their routine work is the care of individuals
- Appropriate ethical and professional behaviour
- Organizational and time management skills
- Ability to reflect on practice, thus facilitating continuing professional development
- A balance of professional and personal lives.
Teaching in a general Practice Setting
There are many ways that teaching can be delivered in general practice. Often registrars have the perception that teaching has to involve direct contact, set topics and a lot of information being passed from the teacher to the learner.
Work based learning affords the teacher the opportunity to be creative. Since the unique feature of workplace learning is the acquisition of skills and knowledge while performing real work tasks, it seems logical that the teaching and learning should be linked as much as possible to the day-to-day tasks of the general practitioner. As you are aware differences in learning and teaching styles means that some activities are more appealing than others. However this does not mean that a variety of activities cannot still be adopted.
Some suggestions include:
- The registrar sitting-in with all the practice partners
- The supervisor sitting-in with the registrar (a)
- Spending some time working in the reception area
- Case discussions
- Audit activities
- Review of medical records
- Personal reflection time (b)
(a) Sitting-in with the registrar is an important aspect of teaching; it enables the supervisor to directly observe the registrar's skills with respect to communication with patients history-taking, physical examination and problem solving. We would strongly encourage all supervisors to do this at least twice in the term, so that any gaps that are identified in these areas can be addressed throughout the term's teaching.
(b) Reflection on learning activities is also important. Learning is most powerful when it is anchored in the learner's practical experience, but simply having the experience does not automatically lead to learning. Reflection is the activity that links experience to learning (2).
In addition, other activities that some GP supervisors have found useful include:
- Visits with local pharmacists and other health professionals
- Visits with local specialists
- Visits to local community centers.
The cycle of experiential learning
One of the fundamental principles that drive experiential learning is the patient challenges that present to us in our day-to-day practice. An important part of learning from these challenges is reflection, and in particular reflection that is guided by a mentor. This is one of the crucial roles that GP supervisor fulfil for registrars.
1. Richard Hayes. Practice-based teaching. Eruditions publishing, Australia. 1999
2. Schon DA. Educating the Reflective Practitioner. San Francisco. Jossey Bass. 1987.