Tag Archives: teaching

In-situ teaching, training & feedback

Pre-list briefing, explore current position of trainee(s) and what they would like to achieve (as objectively as possible) during the day, and achieve the following at post-list briefing:

  • Trainee to have:
    • Acquired new or developed/reflected on existing¬†knowledge
    • Learnt new , developed or reflected on existing technical skill
    • Learnt new, developed or reflected on new non-technical skill
  • Feedback from trainer to trainee – positive and negative (constructive)
  • Feedback from trainee to trainer – positive and negative (constructive)

(If more than one trainee, senior can teach the junior, which feedback on teaching content and methods from consultant +/- trainee)

Post-list:

  • Private room
  • Do the above!
  • Feedback on the process

 

I found this worked very well!

 

 

Simulation ‘debriefing with good judgement’ – a useful technique

Model:

Frames -> actions -> results

Use ‘advocacy-inquiry’ to elicit frames that governed trainees’ actions:

  • state the observed actions/results (advocacy)
  • explore the frame that led to that with genuine curiosity (inquiry)

Facilitator tests their views of the situation against the trainees’ view rather than adopting the position of being the holder of a single truth.

Phrases:

What/how were you feeling…

Help me to understand why…

What/how were you considering…

What was going through your mind…

What was concerning you…

What/how were you thinking…

I am curious as to…

I am wondering…

Anyone else have a thought…

=> Effective, reflective debriefing leads to new frames, not just new actions.

What does an excellent anaesthetist look like?

J. Larsson et al (BJA, 2013) say he/she is:

  • structured, responsible and has a focused way of approaching tasks
  • clear and informative, briefing the team about the action plan before induction
  • humble to the complexity of anaesthesia, admitting own fallibility
  • patient centred, having personal contact with the patient before induction
  • fluent in practical work without losing overview
  • calm and clear in critical situation, being able to change to a strong leading style

 

A.F. Smith et al (BJA, 2011) found the most highly ranked attributes were:

  • ‘strives for excellence’
  • innovative/original
  • good communicator
  • teacher
  • clinical skills