What follows is my reflections of the teaching the consultation module I participated in, as part of my PG Cert for education in primary care.
Created on Thursday, 07/07/2011 4:01 PM by Hussain Gandhi
My final essay for these modules, was enjoyable to write. The analysis of the consultation teaching, and my use of feedback was topical, but at the same time made me appreciate the difference between Pendletone and ALOBA. I did learn about other methods as well (PEE and SETGO). I must admit however a penchant for Pendleton as i find it easier to remember, the students themselves are more aware of it, and also it does provide adequate structure. As commented I find ALOBA frustrating, as it works well when a need is known, however more often particular with the students I work with, they struggle to identify a need, and are more keen to develop skills and understanding as time passes.
In the context and content however I have changed my way of teaching as a result of my essay, working more with an ALOBA style when working with individual students aims, and PENDLETON in groups.
The second day focused on the use of simulated patients for teaching students. Having worked with SPs before I was quite comfortable with the situation, both as participant and in teaching with the SPd, this session more helped me confirm what I know already.
However learning different methods of experiential learning, using the SPs to change tact and come in and out of character at various points allowed a certain variability that I found useful.
SPs are expensive to use in clinical practice teaching, but maybe using the group more would be a better method, as ad hoc, similar to teaching methods I have ue (see essay in module 1).
Theafternooon focused on the paper by skelton, which I found so difficult to comprehend that I could not and sat observing the points made by my colleagues. I had really struggled with this material and to be honest still do. However involving myself in the discussions helped my understanding a little.
The work on diversity opened up a lot of discussion, consulting in diversity methods of consultations etc showed how much there is to learn and try and particular points on consultation length and ethnic understanding of points I have reflected upon for appraisal given cases I have dealt with since
This day was exhausting. A full day on group work looking at how we can improve our teaching styles. Each person brought various different problems and ways to attenuate the learning process. For myself tackling inter-professional variances within a group is a great challenge, and one I struggle with in practice. Using the group help me identify several tactics in terms of inductive learning, group engagement, and back up plans for each teaching session. My colleague Abi really hit home how difficult teaching can be with disinterested learners, and how important it is to target their learning needs before hand and not assume that what I am teaching is relevant.
we also spent some significant time on ALOBA as the teaching tool, it help me understand how feedback can be used as a teaching tool (see my essay), but also how much i dislike ALOBA as a tool. I find it infuriating as most often I don’t have a particular learning need, and even if I do, it generally doesn’t change after running something unless it solved. It probably is me, but as a person using ALOBA for me I find constraining, and irritating. However when using for other people , as mentioned particular when a particular learning need has been identified, it can be very effective.
The other aspect I learnt was the importance of having a clear agenda, and that sticking to it is vital to complete teaching aism. This is most important for times aspects,and sometimes rigdity with timing is needed so all can be covered.
Teaching and learning in a diverse environment is just that, diverse. My experiences have been limited from a teaching POV, as most my students at present have been fully English speaking students, though from diverse backgrounds, but all respectful of this. As a learner I have had slight more experience. During CSA training coming across colleagues who struggled with the concept of the exam, and the nuances involved due to heavy favoring of typical English consultations, with possibly only one based as a 3way or non English speaking consultation. This is an interesting point and more so for those trained in areas of high ethnic minorities where the ability to practice for an exam assessed predominantly for one patient group is hampered by day to day working in another.
Working with such colleagues also raises issues in terms of language nuances, slang and manner. A colleague of mine spoke abruptly, directive, paternally and to some seemed rude, however he was Indian trained and this was just they way his training had made him consult, which is also what the patients expected. I saw this most when i worked at an international medical unit in India where, the patients by preference went to see him over myself, citing afterwards (through use of mystery family members) that it was his directive style they preferred over my patient centered approach.
The teaching methods of the consultation, were varied, we initially had multiple uses of styles, from experiential learning via looking at each others consultation videos, a more group inductive form by using the group itself to bring about ideas and analysis.
the pre mid and during learning that used the articulate system was great way of creating blended learning, by using tech and slides appropriately, and with the added human element of voice direction. I felt this set the course apart from others and allowed a more conducive learning experience.
The analysis of the different models, looking how they interact with our daily consultations and promoting discussion on styles I found very effective and allowed me personally to understand how different models can be used. It also showed me where models can be more effective that others, and what wordings or phrases can be useful.
The use of simulated patients I find very effective, having been ‘raised’ with the concept in medical school and VTS training, felt it was a natural experience, and showed how effective it can be, but also what most surprised me was how much of a humbling experience it appeared to be for others who had not had the same exposure. Made me realise the differences in training that has happened over time and how this can relate to practice make ups and why patients choose one person over another.
My only criticism was the self directed nature of the articles for review, I felt hard to engage with the discussions as these focused more on articles I hadn’t read over ones I had, and as such felt a little excluded from the discussions. Thought the content and discussion were informative, not being able to participate was unsettling, and means as a result I felt I needed to have gone above the task and read all, which would have been against the aims of the task. I thin others felt similar and reflecting that difference in knowledge gap, made me aware how students may feel if they haven’t done the pre-requisite work or more so if they didn’t understand it. It has highlighted my aims to do more in terms of learning needs as a result when looking at work to do, but also not to make pre reading an optional task as felt it promotes the chances of people not knowing certain aspects.