Thank you for attending the preceptor development webinar. We hope you found the information valuable. Items referenced throughout the webinar can be found below.
- ARCH: A Guidance Model for Providing Effective Feedback to Learners
- ARCH Model of Feedback Script for Reading Role Play in Workshop
- Guide to Faculty for Giving Feedback to Students Following First Semester FOSCE Using ARCH
Future Preceptor Development Webinars
July 30 at 7 pm Central Time Five Microskills Model to Facilitate Learning in the Clinical Setting
Speaker contact information
Dennis Baker, PhD
Assistant Dean for Faculty Enrichment and Professor of Family Medicine, Alabama College of Osteopathic Medicine
Emeritus Professor of Family Medicine and Associate Dean for Faculty Development, Florida State University College of Medicine
Written Response to Questions Asked During the Webinar
ADDRESS THE ISSUE OF THE UNINTERESTED STUDENT
I am assuming the focus of this issue/question is how to teach the student who appears uninterested and part of that teaching process is of course to provide feedback if the student is not engaged. Potentially feedback, however it is given, may not impact the uninterested student. I think the key here is to utilize “perspective taking.” Ideally, you want to identify the problem and engage the student as a partner with you in making the situation better. It is important to do this as soon as you see the disinterest as a problem. When you think about the three levels of prevention (primary, secondary, tertiary), you know that if primary prevention is used, then the other two levels may not have to be employed. So, the key, relative to primary prevention, is to have a designated and organized orientation session with the student at the beginning of the clerkship during which you, as the teacher, can set expectations of what the student will be doing. This can be a collaborative effort but, in my opinion, you as the teacher are the leader of this collaborative effort. I do realize each rotation has requirements and those requirements/expectations to be met are decided by the administration and the Clerkship Director. Setting expectations can be done in a sit-down session during a 15 to 20-minute orientation meeting at the beginning of the clerkship. A format for doing this is to require that the student comes to the orientation with three or four written learning objectives they want to accomplish during the rotation. You as the teacher, should also write down three or four learning objectives you want the student to accomplish. Probably you would just take those learning objectives from the approved syllabus. Then you and the student talk with each other about the learning objectives and how they will be accomplished. Another thing to talk about in the orientation is the set of expectations you have about arrival times, departure times, readings, how the teaching process will go in the context of seeing patients, etc. Then after a two-week period have a formal sit-down feedback with the learner using the ARCH model. I think utilization of the ARCH model gives the student a feeling of some control and this may help prevent the issue of disinterest occurring. I am happy to talk with you more about this and I am always available at 850-274-2237.
USING THIS MODEL FOR FEEDBACK ON ROLEPLAY CLINICAL ENCOUNTERS WITH PEERS (DUE TO CURRENT ONLINE-BASED CLERKSHIP STATUS)
I think the idea of having students doing role plays of clinical encounters with peers is a good idea. I am assuming a student is role playing a patient presenting with a problem and then another student is playing the physician and then goes through the process of greeting the patient, establishing a relationship with the patient, then taking a history, and then doing at least some portion of the exam, and then perhaps formulating a differential, etc. I am making the assumption that you, as the teacher, are observing the role play encounter and that you (the teacher) are conducting the feedback session. I am thinking the key is to then use the ARCH model systematically with the student while keeping in mind the separate components the student is to perform (establishing a relationship, taking a history, doing exam, formulating differential). One key to using the ARCH model successfully is to start off with the A (Ask and Allow) by phrasing the self-assessment question very specifically as follows: “What is something you think you did well and something you think you could improve upon.?” The key here is to be specific. Avoid saying something general like, “Well, how did that go?”
The following handout I created for our year 1 and 2 faculty on how to use the ARCH model in the context of giving feedback during Formative Objective Structured Clinical Exams (FOSCEs) and this handout will provide you with additional guidance.
HOW TO MOTIVATE A STUDENT WHILE ENCOURAGING THE STUDENT TOO STUDY MORE ON A SPECIALTY TOPIC?
I am not sure how to answer this question in the context of the ARCH model, but this may be addressed in a future Zoom presentation. However, I am happy to explore an answer to this with the originator of the question. I am always available to talk at 850-274-2237.
HOW DO YOU GIVE FEEDBACK TO STUDENTS YOU DO NOT KNOW VERY WELL?
I am thinking the ARCH model can work even with students you do not know well as long as feedback coming from you is expected by the student. I recommend that the clerkship director should establish with his/her teaching team the expectation that providing feedback to students is expected of all teaching team members and the clerkship director should also let the student know to expect feedback from everyone teaching on the service. In theory the ARCH model should work with any learner, but I can understand that having an established teaching/learning relationship between the teacher and the learner makes the ARCH model easier to use and thus more effective.
HOW DO YOU FOSTER GOOD INTERDISCIPLINARY RELATIONSHIPS?
I am not sure of the context for this important question and perhaps this will come up in a future session.
I WOULD LOVE YOUR ADVICE FOR STUDENTS THAT DO NOT TAKE NEGATIVE FEEDBACK WELL OR STUDENTS THAT ARE NOT AS INTROSPECTIVE ABOUT THEIR SKILLS
I wish I had a magic bullet answer for this question, but I don’t. I know the type of student to which you are referring, and I know this type of student seems reluctant to take feedback and this student is perceived by peers and instructors as difficult because the/she can be inappropriately assertative and frequently does not have the skill to self-assess accurately. You may be familiar with the famous Saturday Evening Post triple portrait magazine cover in which you see Norman Rockwell painting a picture of himself by looking around the canvas at his reflection in the mirror. The message being that we need to see ourselves and represent ourselves realistically. Another version of this same theme shows a little beagle type dog painting a picture of himself but what he sees in the mirror is not himself but a German Shepard instead. In medicine we call the student who sees him/herself in such way as “The student from hell.” So, my advice regarding this student is “don’t take him/her on by yourself. Get administrative help ASAP. On the other hand, if you see the student is not the Student from Hell, then I think it is important to ask the student to self-assess on a regular basis so that the student forms the habit of self-assessing in a realistic way with your help. So, this way you are helping the student form the new habit of being metacognitive. Stephen Covey said, “We make our habits and our habits make us.” So, you can help the student create the new habit of self-assessing accurately.
WOULD THIS MODEL WORK WHEN GIVING FEEDBACK TO SMALL GROUPS?
I am thinking it definitely would work with giving feedback to small groups. I think each part of the model could be presented to the group and you could get both individual and collective responses. You might even try having the group work together to provide a unified response to each part of the model. The key is to really think through how you would want to see this go but it seems to me that having the group work together to have a unified response to the questions you would ask as you address each part of the model would be a way to have the group to enhance their teamwork.
I WONDERED IF YOUR PRESENTATION APPLIES TO RESIDENTS AS WELL AND ARE THERE DIFFERENCES
The model definitely works for residents. The teacher you saw in the video (Suzanne Bush, MD) uses the model routinely with her residents. And the more she uses it with them the more efficient the model becomes. For example, she told me that after using the model with them, each resident comes into an evaluation session with her and just automatically starts the session with a statement of what he/she is doing well and what he/she need to improve on. In other words, she has her residents habituated to do the A part of the ARCH model without her having to ask for self-assessment. This saves time and makes the model more efficient. She told me that early on she learned the need to have the resident go to his/her computer and write up the improvement plan and I am willing to bet you that she is sure to remind each resident to do this each and every time she has a feedback with them because this is a part of the model that busy residents will tend to either forget or hope the residency director forgets.
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CONTACT INFORMATION FOR DMU CLINICAL PROGRAMS
We truly appreciate individuals who are willing to give back by teaching our future healthcare providers. Preceptors do what no textbook or classroom can accomplish. If you are interested in becoming a clinical preceptor for DMU students, please use the appropriate link below to contact the clinical affairs program.
- College of Osteopathic Medicine (DO and MD) – Website and Email
- Interested preceptors for the College of Osteopathic Medicine are encouraged to complete the online preceptor application.
- College of Podiatric Medicine and Surgery (DPM) – Website and Email
- Doctor of Physical Therapy Program (DPT) – Website and Email
- If your site is interested in learning more about the DPT clinical education program or about becoming a clinical partner, please complete the clinical partner questionnaire.
- Master of Science in Physician Assistant Studies Program (PA) – Email
CLAIMING CREDIT FOR PRECEPTORING DMU STUDENTS (DO AND MD ONLY)
To learn more or request credit for preceptoring DMU osteopathic medical students, please visit the Request for Preceptor Credit webform.
- DO - The current AOA reporting cycle is from January 2019 to December 2021. Hours submitted prior to January 2019 will not be accepted. The submitted hours are reported to the American Osteopathic Association (AOA) on the physician's behalf on a quarterly basis (February, May, August, November). The hours are eligible for Category 1-B credits which can be utilized for licensing purposes. A maximum of 60 AOA Category 1-B credits for preceptoring may be applied to the 120-hour, 3-year requirement. AOA board certified physicians must earn a minimum of 50 specialty CME credits in each primary specialty every three-year cycle. These credits may be earned in Category 1 or Category 2 and will meet part of the minimum CME requirements for AOA board certification. When DMU submits the osteopathic physicians preceptor hours to the AOA, they will assign specialty credits as appropriate. No additional documentation is needed from the osteopathic physician. For additional information regarding specialty credits, please visit the AOA CME Specialty Credits website.
Des Moines University (DMU) is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. DMU designates this program for AOA Category 1-B credits for a maximum of 40 hours per week and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.
- MD - DMU is an AOA residency and teaching residents, medical students or other health professionals meets the requirements for AMA PRA Category 2 Credit™. The hours are self-reported by the physician and should include the activity title or description, subject or content area, date(s) of participation and number of credits claimed.