Teaching and Learning Toolbox

The role of learning facilitator and teacher are probably the most apparent of all the GP supervisor’s roles.​

For teaching and learning specific to the consultation, please see:

  • Consultation skills toolbox
  • GPSA consultation skills teaching plans

The role of teacher is the probably the most apparent of all the GP supervisor’s roles.

Resources

  • 2014 AFP paper. GP supervisors – an investigation into their motivations and teaching activities.
  • In this brief video, Nicole Higgins talks about the reasons supervisors teach, and the learning journey.

Resource

  • In this video, Dr Simon Morgan gives a brief overview of practice-based teaching and formal teaching.

Resources

  • Informal teaching webinar and FAQ 
  • In this video, Dr Simon Morgan gives a brief overview of informal teaching.

Resource
In this video Dr Nicole Higgins discusses disruptive teaching.

Resources

Learning needs identification is the process of using tools and methods to uncover the learning needs of the registrar, both known and unknown. These include clinical topics, as well as other domains of practice such as professionalism, communication skills, and organisational skills.

Resource
In this 13 minute video, Dr Simon Morgan discussed the key aspects of ‘what to teach’ and learning needs assessment.

One of the core roles of the supervisor is to assist their registrar to identify their learning needs and plan their learning, using a range of resources and tools.

Resources

Apart from clinical content, there are a range of important aspects of general practice that supervisors should focus teaching and learning.

Resources

There are a wide range of possible teaching and learning methods that the supervisor can employ. Ideally, supervisors should use a diversity of methods to make the learning experience engaging and rewarding for the registrar (and themselves!). Each method has particular strengths and/or shortcomings, and therefore the specific method should be matched to content and registrar leaning needs.
Most teaching methods can be ‘reversed’, where the supervisor takes on the role of learner. This can be a powerful teaching technique and supports collaborative learning.

In this video, Drs Tony Saltis and Simon Morgan give an overview of formal teaching and learning methods.

There is no better way for a GP supervisor to assess (and teach) their registrars clinical, consultation and communication skills than by directly observing their interactions with patients. Direct observation, or ‘sitting-in’, is known to be acceptable to the patient, as well as highly regarded as a learning experience by GP registrars.

Resources

Video recording of consultations has all the advantages of direct observation without the potential intrusiveness of the observer being in the room. Its strength lies in the capacity for the registrar to critically watch the encounter as a third person. Analysis of the recording allows stopping and rewinding to assess a range of communication and consultation skills, and scrutiny of registrar and patient behaviours. Of importance, recent changes to Australian privacy legislation have impacted the use of videorecording of consultations.

Registrar observation of supervisor consultations has particular utility in teaching communication skills, time management and a range of specific consultation skills. It is commonly employed at the start of the training term as part of orientation to the practice. Registrars should take on the role of active participant rather than passive observer and be willing to offer basic feedback to their supervisor.

Resource

The most common practice-based teaching and learning method is problem case discussion (PCD), where the registrar presents their challenging patients to the supervisor and seeks guidance on diagnosis or management. While meeting the registrar’s immediate patient care needs, PCD also allows the supervisor to assess and teach on the registrar’s clinical knowledge, clinical reasoning skills and tolerance of uncertainty.

Resources

Random case analysis (RCA) has been described as ‘one of the most powerful teaching methods we have at our disposal’. It allows identification and exploration of areas of unconscious incompetence and is a particularly effective method of exploring a registrar’s clinical reasoning. RCA has educational utility for all stages of learner, and across all levels of competence.

Resources

Reviewing test results by ‘inbox review’ is an effective method to address rational test ordering, but also provides an ‘entry point’ for broader case discussion. Test result audit and feedback has a specific focus on exploring clinical reasoning and using hypothetical scenarios to extend registrar skills.

Resource
2016 AFP article ‘Test result audit and feedback (TRAFk) as a supervision method for rational test ordering in general practice training’

Near misses and critical incidents are unfortunately not uncommon in general practice. While potentially distressing for the GP involved, critical incident review (or significant event analysis) has been strongly promoted as a quality assurance activity.

Resource

Most practice-based teaching is based around assessing and managing a patient presentation like cough or headache, rather than discussion of a clinical topic, like asthma or migraine. However, teaching about specific topics, whether they be diagnoses e.g. lupus, patient populations e.g. adolescent health, or themes e.g. travel medicine, can be a valuable teaching method.

GPSA Teaching plans.

Physical examination skills may be lacking in registrars. Demonstration of physical examination skills, either on real patients, or on the registrar (where appropriate) is a valuable teaching method.

Resource

Best practice involves starting with a ‘big picture’ concept of the skill and its place in clinical care and then the skill becomes fixed through deliberate practice with specific, constructive feedback based on observation.

Resource
2011 AFP article ‘Teaching procedural skills in general practice’ Teaching a Skill

Role play has particular strengths in communication skills development but is also well suited to discussion of ethical issues and management of uncertainty. Role plays are typically used in small group learning but are readily adaptable to the one-on-one format. They are highly interactive, and rather than just talking about a topic, focus on the ‘doing’. As a result, learners generally find them a deep and memorable learning experience.

Clinical audit and feedback have been found to lead to improvements in clinical practice. Audit can therefore act as a powerful teaching tool. It allows a critical review of current practice, highlights the need for specific knowledge and skills, and encourages self-reflection. Audit may be informal and small e.g. reviewing the prescribing patterns of the past five patients with UTI, or formal and more comprehensive. One of the most common examples is a prescribing audit.

Being involved in teaching other learners, so-called ‘near peer teaching’ is a well-recognised driver of learning. Registrars who teach have been shown to demonstrate enhanced knowledge retention, self-reflection, time management, and leadership skills.

Resource
AFP article ‘General practice registrar teaching roles – is there a need for shared understanding?’
Thampy H et al. Near peer teaching in general practice. BJGP 2019; 69 (678): 12-13.

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Date reviewed: 26 July 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
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