The Minnesota Rural Health School

1
The Minnesota Rural Health School

• The One Minute Preceptor
• Presented by Terry L. Lewis
• MPAS, PA-C

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The One Minute Preceptor

• Used and reformatted with the permission of David
  Irby, PhD

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Get a Commitment

• Student presents the case
• Preceptor-What do you think is going on here?
• Rationale - How does the student interpret the
  data?

4
Examples

• What do you think is going on here?
• What would you like to accomplish during this
  visit?
• Why do you think the patient has been
  non-compliant?

5
Probe for Supporting Evidence

• Student has presented case and looks to you for
  confirmation or alternative
• Preceptor - Ask for evidence
• Rationale - Identifies thought process

6
Examples

• What were the major findings that led to your
  conclusions?
• What else did you consider? What kept you from
  that choice?

7
Teach General Rules

• Provide general rules, concepts or
  considerations, and target them to the learners
  level of understanding - When this happens, do
  this
• Rationale -understanding better

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Examples

• If the patient only has cellulitis, incision and
  drainage is not possible. You have to wait until
  the area becomes fluctuant to drain it.
• Patients with UTIs usually experience pain with
  urination, increased frequency and urgency. The
  UA should show bacteria, and WBCs and may have
  RBCs.

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Tell them what they did right!

• Take the first chance to comment on 1) the
  specific good work and 2) the effect it had.
• Rationale - Skills in learners that are not well
  established need to be reinforced.

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Examples

• Obviously you considered the patients finances
  in your selection of a drug. Your sensitivity to
  this will certainly contribute to improving her
  compliance.
• You did not jump into her complaint of abdominal
  pain, but kept that open until the patient
  revealed her real agenda. That will save a lot
  of unnecessary workup and will get to the real
  heart of her concerns first.

11
Correct Mistakes

• When the learners work has demonstrated mistakes
  or misunderstanding
• Correct quickly
• Rationale - Mistakes left unattended have a good
  chance of being repeated!!!

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Examples

• You might be right that this childs symptoms
  are probably due to a viral upper respiratory
  infection, but you cant be sure it isnt otitis
  media unless youve examined the ears.
• I agree that the patient is probably
  drug-seeking, but we still need to do a careful
  history and physical examination.

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Constructive Feedback

• Is descriptive rather than evaluative
• Is specific rather than general
• Focuses on behavior rather than personality
• Shares information
• Is well-timed

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Constructive Feedback Continued

• Is appropriate in amount
• Is offered rather than imposed
• Can be verified
• Pays attention to consequences
• Builds relationships