Below is information about teaching in various venues or using various paradigms. These include active learning, on-line or hybrid teaching, large group presentations, small group facilitation, and clinical teaching.
Active learning is defined by ABLConnect as "non-passive engagement by students in the learning process." Active learning may take place in small groups or in large classrooms, and may vary from a 2-minute opportunity for students to turn to a partner to discuss a difficult concept to a large group project spanning the semester. Here is a link to some active learning instructional resources. Below is a review of active learning strategies from the UMN Center for Education Innovation, ideas from faculty members in the College regarding active learning, and an article discussing flipped classrooms, as a model of active learning.
- Active Learning Strategies – Mary Jetter – Center for Teaching and Learning
- Peer Discussion on Active Learning
- The Flipped Classroom: A Course Redesign to Foster Learning and Engagement in a Health Professions School
Clinical teaching is complicated by the requirement for clinicians to provide excellent clinical service while permitting students to practice clinical skills including history-taking, physical examinations, and clinical reasoning. Posted below are a number of manuscripts describing various aspects of clinical teaching. The manuscript by Pascoe et al describes a couple of specific techniques to advance clinical reasoning in students, including the SNAPPS model that was described by Dr. James Nixon on Education Day 2016.
The One-Minute Preceptor
The One-Minute Preceptor
The One-Minute Preceptor model consists of five steps. Step 1 = get a commitment; this is not about gathering more information and instead is about asking the student what they think is happening. Example questions might include, "what do you think are the most likely diagnoses", "what laboratory tests do you think we should ask for", and "how do you think we should treat this patient?" Step 2 = probe for supporting evidence; this is about asking the student why they made their specific choices in the first step. Example questions might include, "what factors in the history and physical examination support that diagnosis", or "why would you choose that particular medication"? Step 3 = teach general rules; this is about providing the learner with relevant information about the diagnosis and management of this kind of case. Step 4 = reinforce what was done correctly; this should be specific feedback describing their behavior. An example might include, "it was very good that you took time to talk to the client about lifestyle factors that might make tick exposure more likely for this cat." Step 5 = correct mistakes; this again should be specific feedback, such as, "I agree that we likely could get some great information from an MRI but with this dog's acute collapse and newly identified significant cardiac murmur, general anesthesia probably is contraindicated at this time." This technique permits the clinician to learn much about the knowledge and thought processes of the learner, encourages teaching to the appropriate level, and is well-studied. It requires some practice for clinicians to use the model consistently and may be difficult if students have not collected enough information during their initial examination to readily permit an in-depth discussion.
The SNAPPS model consists of six steps. The first step is Summarize. Students are expected to create a concise summary statement that includes key demographics, a temporal pattern for the presentation, and clinical manifestations. An example might be, "Captain is a 3 year old castrated male Australian Shepherd who lives on a farm and has, for the last 5 days, had intermittent episodes of gagging up thick phlegm and wheezing." The second step is Narrow. The student lists their 2-3 top differentials or diagnostic plans. The third step is Analyze. In this step, the learner explicitly discussed their rationale and the clinician questions them to determine their clinical reasoning process. The fourth step is Probe. This is a chance for the student to ask questions of the clinician. It is an opportunity for the student to consider their own needs as a learner and to use the clinician as an expert resource. The fifth step is Plan, in which the student suggests next steps and works with the clinician to come up with a specific plan. The final step is Select. The student chooses a topic for self-directed learning about the case. This model is learner-centered and gives faculty members insight into student's knowledge and clinical decision making abilities. Training is required for both students and clinicians and learners must feel comfortable admitting what they don't know.
The Aunt Minnie model
The Aunt Minnie model
The Aunt Minnie model is an official name for the kind of clinical teaching that has been done for many years. It is called Aunt Minnie because it is about pattern recognition - if you see someone who dresses like your Aunt Minnie, sounds like your Aunt Minnie, and looks like your Aunt Minnie, she probably is your Aunt Minnie. Students state the main problem for which the patient was brought in, their initial impression, and their first thoughts about diagnostic and treatment plans. The clinician then sees the patient without the student, and discusses the case with the student afterward. The primary advantage to this model is that experts rely heavily on pattern recognition for diagnosis and this pushes students toward building their own body of experience about common disorders. It is also quick. Research suggests that learners usually are right in their first impressions when seeing common disorders. The primary disadvantage of this model is that it promotes snap judgments and may promote other errors in clinical diagnosis. For example, a learner may make assumptions that all Cocker Spaniels have ear infections and not do an examination sufficient to identify other causes of the dog leaning its head to one side. Another error is premature closure, where students fail to perform diagnostics beyond those needed to verify their first impression, potentially missing the correct diagnosis. It is also ineffective for very novice or struggling students.
Drs. Robert Washabau and Peggy Root identified clinical teaching paradigms used at the College; that manuscript is below and the abstract is included here for your convenience - Course coordinators were surveyed and course syllabi reviewed at the University of Minnesota College of Veterinary Medicine for types of teaching paradigms used for clinical training and extent of those varying types of teaching in large animal, small animal, and non-species-based rotations. Show-and-tell, or apprenticeship, was the most commonly used teaching paradigm. Other teaching paradigms, in decreasing order, included topic rounds, case rounds, critical scientific reading / evidence-based medicine, assignments and other assessments, games, and discussion of roles in society / ethics. Apprenticeship teaching was more common in small animal rotations and topic rounds was more common in large animal rotations; this may be a reflection of caseload. Specific teaching methods, tools, and unique learning opportunities are described.
Manuscripts describing various aspects of clinical teaching
- The Complex Role of Veterinary Clinical Teachers: How Is Their Role Perceived and What Is Expected of Them?
- Feedback and Reflection: Teaching Methods for Clinical Settings
- The Art of Precepting: Socrates or Aunt Minnie?
- Challenges and Responsibilities of Clinical Teachers in the Workplace: An Ethnographic Approach
- Maximizing Teaching on the Wards: Review and Application of the One-Minute Preceptor and SNAPPS Models
- Clinical Teaching Paradigms at the University of Minnesota College of Veterinary Medicine
- Making the Most of Five Minutes: The Clinical Teaching Moment
Large Group Presentation
Large group presentations at the College most commonly involve lecturing. Some argue that students are too passive in lectures, which does not promote their learning. Others argue that a well-presented lecture is an efficient way to help students see how an expert in a given topic organizes that information and stresses what is most important.
"What To Do When You're Losing Your Audience" is an article talking about how to change things up in lecture to try to maintain student attention.
- Reconsidering the Lecture in Modern Veterinary Education
- Limitations in experimental design mean that the jury is still out on lecturing
- ABC of learning and teaching in medicine: Teaching large groups
There is a growing interest in providing students with independent learning materials on-line, often with the intention of using face-to-face time to work with that material. Below are articles talking about creating a flipped classroom and about using cases for independent study.
- The Flipped Classroom: A course Redesign to Foster Learning and Engagemnt in a Health Professions School
- Interactive Clinical Cases in veterinary Education Used to Promote Independant Study
The Online coursework Teaching Seminar document is information about online and hybrid courses that was presented by Peggy Root and Ryan Rupprecht as a teaching seminar in 2016
Small Group Facilitation
Working with small groups varies from large group presentations in that the instructor is more often the "guide on the side" than the "sage on the stage". Below are two articles with good tips about small group facilitation.
- Twelve Tips For Effective Small - Group Teaching in the Health Professions
- ABC of learning and teaching in medicine: Teaching small groups