The educational roleIdentifying opportunities for clinical teachingThere are many situations which occur on aday-to-day basis in a clinical setting which can beturned into opportunities for clinical teaching. Whileit is beneficial to allocate specific time for teaching(when required), using opportunities as they becomeapparent can be beneficial to supervisees.Some of the forums where teaching can occur include:• in the presence of patients;• during case discussion;• during treatment planning;• interdisciplinary (i.e. with other oral health disciplines);• interprofessionally (e.g. with medicine and allied health).Voices fromthe fieldI am a very patient person, so watchinga trainee attempt a procedure slowly doesnot concern me. I don’t mind if a traineetakes a while to complete the treatmentand I am prepared to demonstrate and tutorthe trainees as many times as required.However as a clinical supervisor I amaware that I may need to step in to speedthings up if the trainee is running overtimeor the patient has had enough treatmentfor that appointment. I know that it isa fine balance between allowing the traineeto improve their skills and taking overthe treatment.44 <strong>HETI</strong> The Superguide FIRST EDITION
Developing clinical skillsTips for developing clinical skillsThe educational roleSkills training can begin with virtual experience(e.g. texts, scripts, videos, online tutorials, simulations,role plays) but it has to be completed in the workplacewith real patients. Supervisors need to be ready toteach a skill when the opportunity arises.A four-step approach to teaching skills describedby Walker and Peyton 6 and adopted in Teaching onthe Run 7 is:1. Demonstration: Trainer demonstrates the skillat normal speed, without commentary.2. Deconstruction: Trainer demonstrates the skillwhile describing the steps required.3. Comprehension: Trainer demonstrates the skillwhile the supervisee describes steps required.4. Performance: The supervisee demonstrates theskill and describes steps while being observed bythe trainer.• Don’t forget fundamentals: hygiene and infectioncontrol, patient communication, consent,and introductions.• Demonstration: make sure the learner can clearlysee what you are doing. Demonstration by thesupervisor can be combined with performanceby the learner.• Integrate theory with practice: that is, not onlydemonstrating skills but explaining the logicand the evidence behind the practice. Thishelps to develop clinical reasoning.• Don’t teach everything at once: particularlyfor the demonstration of more complex skillsor procedures. Not every step needs to be taughtin every encounter. Begin by establishing whatthe supervisee already knows. Review theunknown steps in more detail.• Provide opportunities to practise skills: makingtime and space available for the superviseeto be hands-on, breaking procedures into steps,providing direction and sharing care. Repetitionis the key to skills training, with the focus ofteaching building on competency.• Use collaborative problem solving: givesupervisees a clinical problem and work withthem towards a solution.• Give feedback: that is timely, specific, andconstructive. Ensure feedback is given in anappropriate environment. Good providersof feedback also invite feedback from thesupervisee, with a view to improving theirteaching technique.• Provide appropriate learning resources: knowingwhat is available to help supervisees developa deeper level of understanding.6 Walker, M. & Peyton, J. (1998). Teaching in theatre, in Peyton JWR, editor, Teaching and learning in medical practice, Manticore Europe Ltd,Rickmansworth, UK, 171-180.7 Lake, F. & Ryan, G. (2006). Teaching on the run: teaching tips for clinicians, MJA Books, Sydney.FIRST EDITION<strong>HETI</strong> The Superguide45