Guest author: Lydia Bunker, MD, hospitalist at MGUH
The One-Minute Preceptor method provides a structured approach for clinical preceptors to integrate teaching into real-time interactions with medical learners following a patient encounter. Initially named “Five-Step ‘Microskills’ Model of Clinical Teaching,” this framework was developed in 1992 by Jon Neher et al. and consists of five steps, outlined below.
Get a Commitment: Encourage the learner to make a clinical decision.
“What do you think is going on with this patient?”
“What tests do you feel are indicated?”
This promotes intellectual engagement and patient ownership.
Probe for Supporting Evidence: Encourage the learner to reflect on their reasoning.
“What are the major findings that support this diagnosis?”
“What factors did you consider when selecting that medication?”
This allows the preceptor to understand the learner’s thought process and identify gaps in their clinical reasoning skills.
Teach General Rules: Offer 1-2 high-yield, evidence-based teaching points relevant to the case.
“In patients with acute pulmonary emboli, assessing for the presence of right heart strain (as evidenced by an elevated BNP/troponin or seen on echocardiography) is essential to choosing between simple anticoagulation and more advanced treatments such as thrombolysis or thrombectomy.”
Reinforce What Was Done Well: Provide specific positive feedback to encourage desirable behaviors or practices and build the learner’s self-confidence.
“I noticed that you considered possible side effects in choosing an appropriate antibiotic. That will help ensure the patient can complete the course and minimize the risk of rehospitalization.”Correct Mistakes: Respectfully correct errors in medical knowledge or clinical reasoning, focusing on constructive feedback to guide learner improvement.
“I agree that it is reassuring that the patient’s colonoscopy was normal two years ago, but we cannot ignore the presence of new unexplained anemia, so we should refer this case to a gastroenterologist and consider repeating an endoscopy now.”
The One-Minute Preceptor model emphasizes learner-centered teaching, promotes clinical reasoning, and integrates direct feedback into patient care. Its flexible structure can easily be modified to suit various learner levels and clinical disciplines. This practical model can help physicians become more effective and efficient teachers in the busy clinical setting.
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