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One Minute Preceptor

What is the "One Minute Preceptor"?

Knowles

The "Microskills" teaching strategy is also called the "one minute preceptor" because of the short time available for teaching (Irby 1987; Neher 1992). 

The microskills provide a simple framework for daily teaching during patient care.This strategy was developed from a combination of educational theory and practical experience and has been validated in teaching medical students and residents in situations such as in the clinic or during hospital rounds.   

The microskills can be used to structure effective precepting encounters that last five minutes or less OR to address problems that arise during teaching sessions.

Like patient care, the microskills technique begins with diagnosis and moves to intervention.   

Also like patient care, the technique requires a rationale for the diagnosis and the intervention progresses from broad general terms to highly specific directives. 

The original microskills uses a five-step approach. We have added an initial "goal-setting" and a final "reflection" stage because we have found that otherwise the learning can be very transient and the student or resident can be overwhelmed by a rapid succession of disconnected learning episodes during a busy clinic or rounding session.   

The Microskills Teaching Model
microskills flowchart
The Microskills teaching model consists of:

  1. Set goals and expectations 
  2. Get a commitment
  3. Probe for supporting evidence
  4. Reinforce what was done well
  5. Correct mistakes
  6. Teach general rules
  7. Encourage reflection and integration

Tips on using microskill techniques

  • Make it clear from the beginning what you expect from the learner in each patient encounter and what is reasonable for them to expect from you.
  • Include time in your expectations. Learners must have sufficient time to do a good job but must gain a realistic perspective of the pace of patient care expected in practice.
  • Allow, or even force, the learner, to present the patient situation without interruption.
  • Make the student commit to a diagnosis or plan and give the rationale for these decisions before critiquing the presentation.
  • Teaching includes indicating references and study materials to work things out as well as telling the answers.
  • It's okay for either preceptor or learner to say "I don't know", as long as the next step is to actively address the problem (e.g. by seeking the missing knowledge, re-analyzing the situation) and actively learning from the situation.
  • Provide both reinforcement of positive actions and constructive correction of mistakes or misconceptions.
  • We've linked examples of challenging learner scenarios to many of the microskills to demonstrate how you can apply them in practice.
  • Coach and enjoy!   

Throughout this module, we'll practice using the microskills strategy in difficult teaching situations:

  • Reba Rambler
  • Harold Hasty
  • Debbie Demoralized
  • Al Arrogant
  • Abby Absolutist   

Resources
The One Minute Preceptor
Virginia Apgar Academy of Medical Educators Teaching Tip
https://www.youtube.com/watch?v=hmKvei3thwQ&t=70s
Take 5: The One Minute Preceptor
Dr. Margaret Dow, M.D., Assistant Professor of Obstetrics and Gynecology, Mayo Clinic College of Medicine
https://www.youtube.com/watch?v=eRBdfXRj5N0&t=79s
The One Minute Preceptor
RPAP Alberta 
https://www.youtube.com/watch?v=P0XgABFzcgE&t=24s
Teaching the One Minute Preceptor
Furney SL, et al. J Gen Intern Med. 2001 Sep; 16(9): 620-624. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495264/

Last modified: Sep 28, 2018
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