One Minute Preceptor


What’s a good way to structure case-based teaching?

This five-step microskill model, often known as the One Minute Preceptor, provides a framework for teaching in the office or emergency room. The structure encourages students to think critically about the case and gives insight into clinical reasoning skills. It also reminds preceptors to provide feedback on performance. Try using it after a learner has presented a case summary.

Get a commitment

  • A question such as “What do you think is happening here?” or “What would be your treatment plan?” helps the learner commit to a diagnosis or treatment option, rather than simply going along with the preceptor’s plans.
  • Avoid prompting or suggesting a diagnosis or treatment plan at this point

Probe for supporting evidence

  • Explore the student’s thought processes. Was this a lucky guess or a well thought out evaluation? Questions such as “Were there any other alternatives you considered?” or “What made you rule out condition X?” are helpful.
  • Questions that rely on rote memory, such as “What is the differential diagnosis for retrosternal chest pain?” don’t aid clinical reasoning.

Teach general rules

  • Try to find a teaching point that can be applied to other situations.

Reinforce what was done right

Correct mistakes

  • Point out any errors.

One-Minute Preceptor in action

Watch the video or review the text below to see how the one minute preceptor works in practice.

Get a commitment

  • “What do you think is most likely behind this man’s delirium?”

Probe for supporting evidence

  • “Did you consider any alternative diagnoses? What makes you favour pneumonia?

Teach general rules

  • “Consider the possibility of a urinary tract infection in any elderly person with delirium.”

Reinforce what was done right

  • “You were right to do a head-to-toe examination to evaluate delirium.”

Correct mistakes

  • “Those fine crackles in the chest are more suggestive of heart failure than of pneumonia.”

If you are interested in learning more about one minute preceptor, visit this link: Teaching with patients

Reference
Neher JO, Gordon KC, Meyer B, Stevens N. A five-step microskills model of clinical teaching.  J Am Board Fam Prac. 1992;5:419-24


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