Reebok 2009
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Transcript of Reebok 2009
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Clinical debriefingClinical debriefingKurt WilsonKurt Wilson
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Intended learning outcomes
Use clinical debriefing to deliver teaching, learning and assessment
Enhance reflective practice
Gain greater two-way feedback through clinical debriefing
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Intended learning outcomes
‘Miseducation’
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MiseducationMiseducation
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Do students learn as intended in community?
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The GP - Good
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The GP - Good
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The GP - Good
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The GP – Not so good
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The GP – Not so good
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The GP – Not so good
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What is meant by “clinical debriefing”
Case presentation
History Examination Investigations
Margin hypothesis Best test?Examination first
Debate and discussion
Tutor led Student led
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What might students get out of it?
… very useful to learnfrom fellow students…
…very good as interactive and varied…
…topic discussion was particularly
useful as the group were able to address learning objectives not raised
in PBL
…feedback was constructiveand very encouraging… …I felt like I was applying my
knowledge & this simulates what will happen later in ‘real life’
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Where does it happen at the moment?
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Aims and objectivesAims and objectivesStudents will use debrief sessions to:Students will use debrief sessions to:– Learn through their own and each other’s clinical experienceLearn through their own and each other’s clinical experience
– Develop presentation, communication, examination and Develop presentation, communication, examination and therapeutic skillstherapeutic skills
– Practice record keepingPractice record keeping
– Discuss ethical issuesDiscuss ethical issues
– Prepare for future undergraduate assessmentPrepare for future undergraduate assessment
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Session overviewSession overviewGroups of 8 studentsGroups of 8 students
2.5 hours long2.5 hours long
Case presentations Case presentations
DiscussionDiscussion
Self directed learning, reflection and teamworkSelf directed learning, reflection and teamwork
Use of generic techniques and structured sessionsUse of generic techniques and structured sessions
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Subsequent sessionsSubsequent sessionsImproving history taking/presentation/group interaction Improving history taking/presentation/group interaction and case discussionand case discussion– Ideas, concerns, expectationsIdeas, concerns, expectations– Margin hypothesis generationMargin hypothesis generation– Examination findings firstExamination findings first– Best test?Best test?
– Sensitivity and specificitySensitivity and specificity
Structure sessionsStructure sessions
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Role play
Case presentation
Use some skills to enhance active learning
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Case one
Margin hypothesis generation
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Margin hypothesis generation
Differential diagnosis Generation
Ranking
Discussion
“Bigger picture”
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Case two
Examination findings first
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Examination findings first
Understand importance of patient historyFew clues from examination?
List of diagnoses and uncertainties large?
“Bigger picture”
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Case three
Best test?
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Best test?
Only allowed one testWhich one and why?
Specificity (false positives?)
Sensitivity (false negatives?)
Positive and negative predictive values
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Summary of cases
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Topics for discussion
Issues surrounding patient centred care
Treating individuals versus population medicine
Disclosure, recommendation and understanding
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Feedback
How might clinical debrief aid the process of feedback between student and tutor?
Are there any of these techniques that might help you to facilitate learning when students present cases to you?